Who Gets to Know They Have COPD?

Prior COPD diagnosis less likely in African Americans and more likely in women

(RxWiki News) Chronic obstructive pulmonary disease (COPD) affects millions of Americans. Unfortunately, millions more don't know they have the disease. According to a new study, race and gender may influence who gets diagnosed.

Results from that study, which was recently presented at a conference, showed that African Americans and men may be underdiagnosed and undertreated for COPD.

"See your doctor if you're having trouble breathing."

The study was conducted by Albert Mamary, MD, Assistant Professor of Medicine at the Temple University School of Medicine in Philadelphia, and fellow researchers.

According to Dr. Mamary, "Race and gender are known to affect the diagnosis and treatment of a number of diseases." And this recent study showed race and gender to be linked to disparities in rates of COPD diagnoses.

For their study, Dr. Mamary and colleagues looked at data of 10,120 people, 8,908 of whom were included in the final analysis. These participants were white or African American and at least 45 years of age with at least 10 pack years of cigarette smoking. A pack year is the number of cigarette packs smoked per day multiplied by the number of years of smoking.

At the beginning of the study, participants were tested with spirometry, a common lung function test. The researchers determined whether participants had a previous COPD diagnosis by asking the following questions:

  • Do you have COPD?
  • Do you have emphysema?
  • Do you have chronic bronchitis?

COPD is the name for a group of lung conditions. Emphysema and chronic bronchitis are the two main types of COPD.

The researchers then measured disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. The GOLD system classifies COPD patients into four stages based on the degree of airflow obstruction. Stage 1 is considered mild, stage 2 is moderate, stage 3 is severe and stage 4 is very severe COPD.

Study results showed that African Americans were less likely than whites and women were more likely than men to have had a previous diagnosis of COPD, regardless of participants' current COPD stage.

Compared to whites, African Americans had higher odds of not having a previous COPD diagnosis:

  • 1.6 times higher odds at GOLD stage 0 (no COPD)
  • 1.6 times higher odds at stage 1
  • 1.9 times higher odds at stage 2
  • 3.3 times higher odds at stage 3
  • 3.7 times higher odds at stage 4

Compared to men, women had higher of having been diagnosed with COPD:

  • 1.9 times higher odds at stage 0
  • 1.4 times higher odds at stage 1
  • 1.6 times higher odds at stage 2
  • 1.0 times higher odds at stage 3
  • 1.1 times higher odds at stage 4

"In our study of almost 9,000 patients enrolled in the COPDGene® study, a cross sectional sample of high risk patients, race and gender were associated with significant disparities in the prevalence of prior COPD diagnosis across all stages of actual current disease severity," said Dr. Mamary in a press release. 

"The underdiagnosis and potential undertreatment of COPD among African Americans that we detected in our study is cause for concern,” he said. “Future research should focus on the factors underlying the race and gender disparities that we found."

This research was presented in May at the American Thoracic Society's international conference. The study has yet to be published in a peer-reviewed journal.

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Review Date: 
May 21, 2013