Should asymptomatic smokers be screened for COPD with spirometry?

Should asymptomatic smokers be screened for COPD with spirometry?

• A. Yes
• B. No
• C. Only if age over 65
• D. Only if there is a family history

Answer: (B)

Not screening asymptomatic adults, including smokers, with spirometry is the preferred approach. Spirometry detects airflow limitation, but in people without symptoms the chance that testing will change management or improve outcomes is low. Screening many asymptomatic smokers would lead to false positives, unnecessary follow-up, anxiety, and added costs, without proven benefit. The most effective initial step for smokers is cessation and risk reduction, while spirometry is reserved for confirming COPD in those who have symptoms such as chronic cough, dyspnea, or wheeze, or when there is a strong clinical suspicion. Therefore, routine spirometric screening in asymptomatic smokers is not recommended.

Not screening asymptomatic adults, including smokers, with spirometry is the preferred approach. Spirometry detects airflow limitation, but in people without symptoms the chance that testing will change management or improve outcomes is low. Screening many asymptomatic smokers would lead to false positives, unnecessary follow-up, anxiety, and added costs, without proven benefit. The most effective initial step for smokers is cessation and risk reduction, while spirometry is reserved for confirming COPD in those who have symptoms such as chronic cough, dyspnea, or wheeze, or when there is a strong clinical suspicion. Therefore, routine spirometric screening in asymptomatic smokers is not recommended.