Chronic obstructive pulmonary disease (COPD) is under-diagnosed in smokers and former smokers at risk for lung cancer, say researchers with the UAB (University of Alabama at Birmingham) Lung Health Center. "Traditional teaching has always been that COPD is found in 15-20 percent of smokers or former smokers," said Chad E. Miller, MD, a fellow in UAB's Division of Pulmonary, Allergy and Critical Care Medicine and principal investigator of the study. "However, our analysis indicates that number is much higher. Our findings suggest that more than half of smokers or former smokers may have COPD." Miller and colleagues studied patients enrolled in the National Lung Screening Trial, which compared chest X-rays versus CT scans for early detection of lung cancer. Miller's team obtained medical information and performed spirometry on 449 trial participants. The spirometry test, a measure of lung function, showed that more than half, or 53 percent, had airflow limitation compatible with a diagnosis of COPD. Only 80 of those 236 individuals had a prior diagnosis of COPD, while only 42, or just 18 percent, had received treatment for the condition. "These findings clearly indicate that COPD is under-recognized and under-treated in patients at risk for lung cancer," said Mark T. Dransfield, M.D., assistant professor of pulmonary, allergy and clinical care medicine at UAB and a study co-author. "Physicians should be more alert to the possible presence of COPD in smokers and former smokers," Dransfield said. November 2006