2020 Volume 35 Issue 4 Pages 586-594
Objective: In Japan, the prevalence of COPD increases with smoking history and age. During a population-based lung cancer screening, we conducted COPD screening of these highly prevalent aged smoking group using a questionnaire. We investigated whether COPD patients could be identified and whether they could be effectively treated. Furthermore, the feasibility and usefulness of COPD screening were assessed.
Methods: A questionnaire, including items from the mMRC questionnaire and other items related to subjective symptoms, such as shortness of breath, cough, and sputum, was distributed among 730 patients who underwent sputum cytology examination during lung cancer screening performed annually in Miyagi Prefecture. Based on the results of the questionnaire, we evaluated the possibility of COPD in all the study participants. Thereafter, we identified patients who required further examination and recommended that they should be examined at our institution or by their family doctors.
After further examination, including lung function tests, treatment with inhalants and smoking cessation guidance were provided as necessary. Two weeks later, a reexamination of the lung function was conducted to confirm improvement of COPD, and the affected patients were referred to a primary care doctor.
Results: Of 730 patients, 306 completed the questionnaire. After evaluating patients for COPD using the questionnaire, 64 patients were selected to undergo a detailed examination.
A pulmonary function test confirmed the diagnosis of COPD in 13 patients and identified four additional borderline COPD cases.
Of 11 patients treated at our facility, six experienced a reduction in the symptoms by ≥ 3 points in the CAT questionnaire after treatment.
Eight people who smoked at the time of pulmonary function test examination were instructed to discontinue smoking, and three people subsequently quitted smoking and three reduced smoking.
Conclusion: Patients with confirmed or borderline COPD were diagnosed using a questionnaire distributed during lung cancer mass screening. Using treatment and intervention, we improved the quality of life of patients and successfully introduced smoking cessation in many cases. Thus, this COPD screening could be considered useful and feasible.
