Chronic obstructive pulmonary disease (COPD) is a common medical illness and a growing public health problem globally. A partially reversible airflow obstructive condition, COPD is largely underdiagnosed in India, and only when it progresses to a worsening situation do patients seek medical care.
The data indicate the estimated burden of COPD in India to be about 15 million (males and females contributing to 9.02 and 5.75 million). COPD causes severe disabilities and a poor quality of life in its advanced stage. Co-morbid conditions like diabetes and heart disease have a great impact on the outcome of COPD in the form of severity, exacerbations, morbidity, and mortality. Hence, COPD patients must opt for routine screening for diabetes and heart ailments.
Screening of COPD in High-risk Groups:
According to Dr Divya Shree J, Consultant - Respiratory Medicine, Manipal Hospital Kanakapura Road, as a multi-systemic disease, COPD should be screened much like heart disease or diabetes, primarily because early detection leads to better patient outcomes. It can slow disease progression and reduce the risk of severe complications.
A simple diagnostic test like a pulmonary function test (PFT), especially spirometry, can easily figure out how much air a person can inhale and exhale, and at what speed. Other diagnostic tools include chest X-rays (CXR) and CT scans, which help in showing lung changes and monitoring treatment responsiveness.
Unfortunately, in most cases, there are no guidelines at present to recommend screening for COPD for asymptomatic patients during seasonal spikes. Unlike heart disease or diabetes, where routine screening is very common, many patients with COPD are diagnosed only after significant lung damage, making late intervention less effective. Even symptoms like shortness of breath and chronic cough are most often dismissed as signs of normal ageing, a smoker’s cough, or being out of shape.
COPD is also known to overlap or exacerbate other chronic issues like heart disease or diabetes, as all three of them share similar risk factors and morbidity rates. Unrecognised COPD in people with heart disease or diabetes can worsen both respiratory and cardiovascular outcomes and lead to complications that require prolonged care and interventions for recovery.
In COPD, studies show early diagnosis and management reduce exacerbation rates, hospitalisations, and economic burden, mirroring the preventive success seen with early detection of heart disease and diabetes. Especially, it helps people with risk factors (smokers, passive smokers, those with respiratory symptoms, and females with biomass fuel exposure) to be on the safer side, managing the disease even before noticeable symptoms begin to appear. Ideally, these patients should begin their COPD screening at age 45 and follow their doctor’s advice for appropriate care if the disease is confirmed.
The early COPD management plan often includes quitting smoking and medications like inhaled bronchodilators to reduce flare-ups and improve overall well-being. Some patients with severe COPD symptoms may need pulmonary rehabilitation to improve lung capacity and prevent the disease from progressing and causing disability.
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