Lung disease underdiagnosed in adults

Many adults may be unaware they're suffering from a respiratory condition that, without intervention, may leave them breathless and unable to walk, a new study suggests.

Chronic obstructive pulmonary disease, or COPD, is a progressive and irreversible blocking of the airway.

Early symptoms of COPD, a term that covers chronic bronchitis and emphysema, include shortness of breath and coughing, which usually emerge over time after age 55.

'These findings suggest that adults who ... with known risk factors for COPD are important targets for screening and early intervention.' — Study authors

But with family doctors frequently overlooking these symptoms in high-risk patients, the disease is underdiagnosed, said Dr. Roger Goldstein of West Park Healthare in Toronto and his co-authors.

The authors studied 1,003 adult patients at three Ontario centres who had smoked the equivalent of a pack a day for 20 years and were over age 40.

COPD was identified in about one of every five patients, or 20.7 per cent, said the study published in Tuesday's issue of the Canadian Medical Association Journal.

More than three-quarters of the patients found to have the lung disease had reported at least one respiratory symptom, but two-thirds of these patients, or 67.3 per cent, were unaware of the diagnosis, the researchers said.

"These findings suggest that adults who attend a primary care practice with known risk factors for COPD are important targets for screening and early intervention," the authors wrote.

Study participants were seeing family doctors or nurse practitioners in Toronto, Ottawa or Sault Ste. Marie, Ont. They were tested with spirometry, the gold standard approach to the COPD. Spirometry involves blowing into a small apparatus to measure the flow of air in and out of the lungs.

Goldstein said the most important step for patients with COPD is to quit smoking. If family doctors show patients how their lung function has declined, physicians are more likely to encourage them to give up cigarettes, Goldstein said.

Rehabilitation programs can also help, reducing the sense of breathlessness and improving quality of life for people whose disease has become more severe, Goldstein said.

Michael Bond, a 52-year-old resident of Kirkland Lake, Ont., found this out after making frequent visits to emergency over the years with what he thought was severe asthma. Bond, a former smoker, says his breathing was so difficult he was barely able to walk five steps.

He was referred to West Park Healthcare, where he was taken off about 75 per cent of his medications after being taught breathing and other exercises to condition his muscles.

"I do believe I have a decent life now," Bond said, noting his other option was a double lung transplant. "When I came in here I was so depressed, upset, I didn't feel there was much left for me. I honestly figured I was at the end of my rope. And I believe my wife felt the same way. She was terrified."

Bond said he had to come to Toronto to receive the rehab and wishes that information about such programs were more available in smaller towns.

In March, another team of researchers reported more that more than 700,000 Ontarians over age 35 — 10 per cent of the province's adult population — live with the disease.