Study highlights hidden lung disease
(CNN) -- Millions of people in the United States are suffering from chronic obstructive pulmonary disease (COPD) and don't even know it, according to a new study.
"It's the Rodney Dangerfield of chronic diseases," said Dr. Sam Giordano, executive director of American Association for Respiratory Care (AARC). But he believes better public screenings and better education for both doctors and patients will help.
AARC is joining the American Lung Association (ALA), the National Lung Health Education Program (NLHEP) and the American College of Chest Physicians and in a national education campaign to raise awareness of the condition.
The groups want to "let people know about the very great impact COPD is having on American lives," explained Dr. Norman Edelman, a scientific consultant and spokesman for the ALA.
COPD is the 4th leading cause of death in the United States, killing more than 112,000 people each year, according to the lung association.
The study, funded by pharmaceutical giant GlaxoSmithKline, highlights two points, said Dr. Jill Ohar, a professor of medicine at St. Louis University and a consultant on the survey. "First, there are many more patients out there with COPD than carry a firm diagnosis from a doctor and, secondly, patients are more symptomatic than they tell."
Researchers interviewed 573 patients who were either diagnosed with COPD, emphysema or chronic bronchitis or had symptoms of chronic bronchitis and were at least 45 years old. They also interviewed 203 physicians in a national sample, with some surprising results, according to Ohar.
When asked about their frequency of symptoms:
What is COPD?
COPD is an umbrella term for diseases that restrict the flow of air out of the lungs. If there is too much "used" air in the lungs, there's not enough room for oxygen-rich air to enter. Emphysema and chronic bronchitis are the primary COPD diseases.
Patients suffering from chronic bronchitis produce excess phlegm in their lungs, which clogs air passages. Symptoms include coughing up excess mucus, shortness of breath and frequent infections. Some 14.2 million people in the United States suffer from chronic bronchitis, according to the lung association.
Emphysema affects fewer people -- about 3 million, according ALA. It is characterized by shortness of breath and coughing. Lung damage from emphysema is irreversible, because the disease destroys small air sacs in the lungs.
COPD often goes untreated because patients often don't tell their doctors about their symptoms or how severe those symptoms are. "One gets a sense that people are too accepting of their disease," explained the lung association's Edelman.
That's especially true of smokers, who tend to cough more and bring up more phlegm.
"It is common for smokers to get up in the morning, wash their face, brush their teeth, cough and spit up phlegm," said consultant Ohar, so they tend not to report it to their doctor.
Also, because most patients are 45 or older, many think shortness of breath is a common part of the aging process. A study conducted by the Centers for Disease Control and Prevention found that at least two thirds of the population of patients with lung disease don't know they have it.
On the other hand, doctors aren't asking patients about these symptoms and aren't testing patients enough, experts said.
Testing in the past has been difficult -- the machines used were very complicated and the data had to be evaluated by an outside laboratory. But now there are simple computers that doctors can use in their offices to evaluate test results and the cost has gone down significantly.
"Patients should have the lung function tested at some point in their life," said Dr. David Mannino, a medical epidemiologist with the CDC. "To know what your lung function is can be an indicator of overall health."
Early diagnosis and earlier treatment can significantly improve the quality of life for patients, said Dr. Tom Petty, chairman of the NLHEP. "The average age for a COPD patient is 53 years -- that's too old," he added.
Smoking a primary cause
While there is no cure for COPD, there are many ways to alleviate symptoms.
Medications, such as broncodilators, can help open clogged air passages. Antibiotics and anti-inflammatory agents may also be prescribed, along with a healthy diet and exercise to strengthen muscles.
But doctors say the best way to avoid COPD is to stop smoking. Smokers are ten times more likely to have COPD than non-smokers, according to the American Lung Association.
"Ninety percent of COPD that we see in the United States is caused directly by smoking -- there's no argument about it," agreed Dr. Gerald W. Staton Jr., a professor at the Emory University School of Medicine.
In the United States, there are more than 47 million people over 18 who smoke and nearly 45 millions former smokers, according to CDC statistics.
After the age of 30, lungs stop growing and lung function begins to diminish. Non-smokers lose lung function at a rate of about 20 cubic centimeters per year. Smokers lose about 4-5 times that much and can exhale about 100 cubic centimeters less air.
"If you smoke and stop, you can expect to regain 60 (cubic centimeters) of lung function per year after two years -- then you could go back to normal aging lung function loss," explained Ohar.
Nicotine patches, gums, inhalers or sprays -- coupled with the prescription smoking cessation drug Zyban -- have been successful in helping patients quit smoking, according to a 1998 study published in the New England Journal of Medicine. But doctors need to do more, one expert said.
"Doctors need to tailor their message to their patient," said Ohar. "If you're talking to a teenage boy, tell him smoking will make him impotent. If you're talking to a teenage girl, tell her smoking causes periodontal disease and will ruin her smile. If you're talking to a middle-aged woman, tell her how smoking will cause premature wrinkles and contribute to osteoporosis."
Results from the most comprehensive national survey of COPD were presented at a news conference Tuesday.
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