At a time when death rates for many diseases are decreasing, those from COPD (chronic obstructive pulmonary disease) are on the rise – up 163 percent over 30 years. Most of this increase is among women, while the death rate for men has remained stable for the past few years.
An inflammatory disease that causes permanent lung damage, COPD involves both the airways and airspaces (the space between the alveoli and pulmonary capillaries). The airway disease is often called chronic bronchitis, and the airspace disease is called emphysema. While COPD is not curable, it is treatable – and it is largely preventable, since more than 80 percent of COPD cases in the U.S. are caused by smoking. In fact, before women began smoking in the 1930s and ’40s, it was considered a man’s disease.
COPD develops gradually. According to the National Institutes of Health (NIH), the typical patient will begin to develop symptoms after smoking for about 10 years, but may not notice them. The first sign is often a cough that comes every morning — a productive (mucus-filled) cough. Coughing will continue, and as the years go by, the patient becomes short of breath during exertion. Without treatment, this continues and worsens, until breathing is extremely difficult. Patients often require hospital care.
“Unfortunately, most patients with COPD are not diagnosed until they are quite far along in the disease,” says Sonia Buist, MD, of the Oregon Health & Science University in Portland. “[They] don’t recognize their shortness of breath as anything other than the natural result of aging or the symptoms of long-term smoking. They often don’t seek help until it’s too late, when as much as 50 percent of their lung function is irreversibly gone.”
To stem the tide of COPD, Dr. Buist urges patients and physicians to learn to recognize the symptoms of COPD and test for it early, especially among smokers. It can be detected with a standard physician’s-office spirometry test. If caught early, symptoms can be treated and quality of life improved. “We need to increase awareness of the disease, especially among women. Standardizing the terminology, using spirometry to confirm a diagnosis, and managing COPD actively can help save lives,” Dr. Buist says.
First published: The MA Report, February 2004
Reviewed: February 2009