MedWire News: The high prevalence of undiagnosed cases of chronic obstructive pulmonary disease (COPD) in the adult patient population registered to a Polish primary care clinic suggests that case-finding is worthwhile, researchers report.

Writing in the journal Thorax, Michal Bednarek (National Research Institute of Tuberculosis and Lung Diseases, Warsaw, Poland) and colleagues report that a “large number of newly detected patients were symptomatic and needed treatment.”

Epidemiologic studies suggest that only a small fraction of COPD cases are diagnosed in the general population. Bednarek and colleagues investigated the prevalence and severity of COPD, and the fraction of patients already diagnosed and treated, in 1960 adult patients in a primary care practice in the Polish town of Sierpc.

The team found pre-bronchodilator airflow limitation in 299 (15%) participants and post-bronchodilator limitation in 211 (11%). COPD was diagnosed in 183 (9.3%) patients, and of these patients, the degree of airflow limitation was mild in 30.6%, moderate in 51.4%, severe in 15.3%, and very severe in 2.7%.

Only 18.6% of the patients had been previously diagnosed with COPD, and almost all had severe or very severe airflow limitation.

“Our study confirmed that COPD affected around 9% of the adult patients seen in a primary care setting in Poland,” the authors write.

They add: “The disease was largely under-diagnosed without spirometry: only patients with severe disease had been diagnosed and treated.”

The team concludes: “COPD case-finding should be done using office spirometry in high-risk patients, smokers, and subjects with respiratory symptoms.”

Thorax 2008; Advance online publication