Millions of smokers AND ex-smokers may have deadly undiagnosed lung diseases

June 24, 2015  15:46

Millions of smokers and ex-smokers may have undiagnosed lung diseases, new research warns.

A study found 55 per cent of people dubbed ‘disease-free’ by lung function tests, which check for respiratory conditions, did have notable breathing problems when checked with more accurate tools.

Many were actually suffering from suffering from the early stages of chronic obstructive pulmonary disease (COPD), researchers said.

COPD is a progressive and incurable condition in which the walls of the airways thicken, and become more scarred and narrowed, leading to breathlessness, coughing and phlegm.

It is incurable, but early diagnosis and treatment can slow down the deterioration of the lungs.  

Study senior author Professor James Crapo, of National Jewish Health, said: 'The impact of chronic smoking on the lungs and the individual is substantially underestimated when using lung-function tests alone.

'Lung disease is common in smokers whose lung-function tests fall within population norms.'

The researchers evaluated 8,872 people ages 45 to 80 who had smoked at least a pack of cigarettes a day for 10 years, or the equivalent.

Most had smoked considerably more, from 35 to 50 years.

About half the participants were considered disease-free, based on their lung-function tests.

COPD is diagnosed by a having people blow as hard and as long as they can into a device called a spirometer, which measures how much air they can blow out in one second and how much total air they can force out of their lungs.

Individual results are compared to population norms and adjusted for age, size and gender.

But when researchers considered other criteria including impairments in physical function, respiratory symptoms, CT scans, use of respiratory medications, and respiratory-specific quality of life, the results were different.

They found that 55 per cent of the people dubbed 'disease-free' had some form of respiratory-related impairment.

CT scans found emphysema or airway thickening in 42 per cent of the disease-free participants.

And 23 per cent had significant shortness of breath, compared to 3.7 per cent of people who had never smoked.

Some 15 per cent walked less than 350 metres in six minutes, compared to 4 per cent of those who'd never smoked.

The disease-free smokers also had considerably worse quality of life than those who'd never smoked.

A quarter of them had scores on quality-of-life questionnaires above a threshold that is considered clinically significant.

Lead author Doctor Elizabeth Regan, of National Jewish Health, said: 'Smokers who have "normal" lung-function tests often have significant respiratory disease.

'Many of those smokers likely have the early stages of chronic obstructive pulmonary disease.

'We hope these findings will help debunk the myth of the healthy smoker and highlight the importance of smoking prevention and cessation to prevent lung disease and other long-term effects of smoking.'

The researchers hope their findings will encourage long-term smokers to get lung CT screenings to detect early stages of lung cancer and COPD.

The research was published in the journal Internal Medicine. 

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