Smith-Sivertsen Tone, Rortveit Guri
Department of Public Health and Primary Health Care, University of Bergen, Norway.
Scand J Prim Health Care. 2004 Dec;22(4):196-201. doi: 10.1080/02813430410006657.
To discuss whether screening for early chronic obstructive lung disease (COPD) is justifiable.
The COPD diagnosis can usually be made by means of spirometry before symptoms appear. General practitioners are these days encouraged, from several quarters, to screen their smoking patients for early COPD. Smoking cessation is still the only available treatment that indisputably improves the long-term prognosis of this disease. The argument for screening is that people will be more easily motivated to stop smoking if they know their lung function results. There is, however, no documentation that this is the case.
Pub Med using the search terms "mass screening", "COPD" and "spirometry".
There is no evidence today that spirometry screening aids smoking cessation.
A large randomized study is needed, in which the independent effect of spirometry as part of a smoking cessation programme is studied. Until such a study has shown convincing results, and has been followed by a cost-benefit analysis in favour of screening, screening for pre-clinical COPD in general practice should not be recommended. However, it is important to diagnose people who may benefit from symptom-relieving treatment, and therefore patients with smoking-related symptoms should be offered spirometry. Finally, the general practitioner should strive to offer smoking cessation counselling to all smokers, regardless of their lung function.
探讨对早期慢性阻塞性肺疾病（COPD）进行筛查是否合理。
COPD通常可在症状出现前通过肺活量测定法作出诊断。如今，多个方面都鼓励全科医生对吸烟患者进行早期COPD筛查。戒烟仍然是唯一能无可争议地改善该疾病长期预后的可用治疗方法。支持筛查的观点是，如果人们知道自己的肺功能结果，就会更容易被激励去戒烟。然而，并没有文献证明情况确实如此。
使用搜索词“大规模筛查”“COPD”和“肺活量测定法”在PubMed上进行检索。
目前没有证据表明肺活量测定法筛查有助于戒烟。
需要进行一项大型随机研究，研究肺活量测定法作为戒烟计划一部分的独立效果。在这样的研究显示出令人信服的结果，并随后进行有利于筛查的成本效益分析之前，不建议在全科医疗中对临床前期COPD进行筛查。然而，诊断出可能从缓解症状治疗中获益的人很重要，因此对于有吸烟相关症状的患者应进行肺活量测定。最后，全科医生应努力为所有吸烟者提供戒烟咨询，无论其肺功能如何。
