COPD underdiagnosed in Chinese lung cancer patients

By Mark Cowen, Senior medwireNews Reporter

Chronic obstructive pulmonary disease (COPD) is underdiagnosed and undertreated among lung cancer patients in China, study results show.

The research team found that just 7.1% of 705 hospitalized lung cancer patients who met spirometric criteria for COPD were diagnosed with the condition. Consequently, lung cancer patients with undiagnosed COPD were less likely to receive appropriate treatment for the latter condition than those with a diagnosis.

"Underdiagnosis of COPD in lung cancer might occur because the symptoms of COPD are mistakenly regarded as the presentations of cancer," suggest Qun-ying Hong (Zhongshan Hospital, Shanghai, China) and colleagues.

"Another explanation might be that priority among lung cancer patients likely shifts to treat lung cancer primarily as the greatest threat to patient survival," they add.

The researchers studied spirometry and other data on 3263 patients who were admitted to hospital between 2006 and 2010 and who had a discharge diagnosis of lung cancer.

In total, 705 (21.6%) patients had coexisting COPD according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) spirometric criteria (post-bronchodilator forced expiratory volume in 1 second/forced vital capacity ratio <0.70).

However, just 50 of these patients received a diagnosis of coexisting COPD.

Among the 643 patients who met criteria for stable COPD, just 174 (27.1%) received treatment consistent with GOLD guidelines, and among the 62 patients with acute exacerbations of COPD, just 29 (46.8%) received appropriate treatment.

The researchers also found that, among patients who met spirometric criteria for COPD, those with a history of smoking had higher COPD diagnostic rates than those without such a history, as did those with a history of respiratory diseases, such as chronic bronchitis or emphysema, versus those without.

Similarly, the COPD diagnostic rate was higher in patients with respiratory symptoms such as chronic cough, sputum production, or exertional dyspnea, than in those without.

Hong et al conclude in Respirology: "Our study shows that COPD is substantially underdiagnosed and undertreated in hospitalized patients with lung cancer.

"There is an urgent need to raise its awareness among both doctors and patients, spread knowledge of COPD guidelines and translate the knowledge into action. Documentation of tobacco exposure, respiratory history and symptoms would help to improve COPD management in this special population."

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