On May 10, 2022, the United States Preventive Services Task Force (USPSTF) released its final recommendation statement on screening for Chronic Obstructive Pulmonary Disease. The Task Force makes recommendations by assigning one of five letter grades (A, B, C, D, or I). Its 2022 grade of D recommends against screening for COPD in asymptomatic adults based on moderate certainty that the service has no net benefit, reaffirming the Task Force’s 2016 recommendation. In developing its recommendations, the Task Force gathered evidence on whether screening in asymptomatic adults improves health-related quality of life or reduces morbidity or mortality; whether treatment of adults with screen-detected or screen-relevant COPD improves outcomes; and, whether there are adverse effects of COPD treatment in this population.
Below is a summary of its rationale for recommendations contained in the latest report, which was also published on the JAMA Network website.
- Benefits of early detection and intervention and treatment
- The USPSTF found inadequate direct evidence that screening for COPD in asymptomatic adults reduces morbidity or mortality or improves health-related quality of life
- The USPSTF found inadequate evidence that treatment of asymptomatic COPD reduces morbidity or mortality or improves health-related quality of life.
- Limitations of the evidence on pharmacologic and nonpharmacologic interventions suggest that treatment benefits in adults with symptomatic moderate COPD are marginal. Therefore, the USPSTF bounds the benefits in asymptomatic adults as no greater than small
- Harms of early detection and intervention and treatment
- The USPSTF found inadequate direct evidence on the harms of screening for and treatment of asymptomatic COPD. Given that the opportunity costs associated with screening asymptomatic persons may be large, the USPSTF bounds the magnitude of harms of screening to be at least small.
Although tobacco use is generally cited as the leading cause of COPD, research shows that other risk factors such as air pollutants and toxins that irritate the lungs can also contribute to the disease. Consequently, it is often reported that millions of adults who may be living with COPD go undiagnosed each year. Yet, the recommendation from the USPSTF is consistent with guidelines from the Global Initiative for Chronic Lung Disease (GOLD) and is supported by the AARC. The Global Strategy for Prevention, Diagnosis and Management of COPD: 2022 Report, states: “…there are no data to indicate that population-based screening spirometry is effective in directing management decisions or in improving COPD outcomes in patients who are identified before the development of significant symptoms.”
The report also provides a clinician summary that may be of interest to respiratory therapists. We encourage our members to read the complete report to gain additional insight into the recommendation.
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