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COPD: the biggest killer disease you’ve never heard of

This debilitating lung condition is still under the radar compared to more commonly recognised health issues, with experts calling for public awareness campaigns

The world is in the grip of a disease that causes the deaths of millions of people every year but has received less attention than other well-known conditions. Around the globe people are struggling with a respiratory problem that ravages their lungs and leaves them struggling for breath or dependent on oxygen. It is hard to detect, cases are rising and patients are often diagnosed very late, when already seriously ill. Many sufferers get progressively worse and too many of them die.

The situation might sound familiar, but the disease being described is not Covid-19. It is COPD, and it is serious and deadly. Yet how many people truly understand what it is? How many are even familiar with the name? COPD might just be the most significant disease you’ve never heard of.

 

Elina, 33, was diagnosed with COPD after suffering with breathlessness and other symptoms for seven years.


The abbreviation stands for chronic obstructive pulmonary disease, which according to the World Health Organization is the third leading cause of death worldwide, causing 3.2m deaths in 2019 – and the numbers are expected to rise every year. It occurs when abnormalities in the small airways of the lungs limit airflow. And while it is often associated with smoking, other environmental exposure such as indoor air pollution can be important too.

John Hurst, Professor of Respiratory Medicine at University College London, says there are three main reasons why COPD has such a low profile given its importance. “Globally, the burden falls very much on low and middle income countries. So it’s out of sight to a certain extent,” he says. The second reason is stigma. “The commonest cause is cigarette smoking, so there can be a reluctance among patients to present because they think the condition is to some degree self-inflicted.”

The third reason, Hurst says, is simply the name. “I think we have an image problem. COPD is not a word. You can’t say it. And so there’s a low ‘brand recognition’ aspect as well.”

COPD covers a group of conditions that cause airflow blockage and breathing-related problems and is sometimes called emphysema or chronic bronchitis, which constitute two related components of this disease. Emphysema usually refers to destruction of the tiny air sacs at the end of the airways in the lungs, while chronic bronchitis is a persistent cough with the production of phlegm resulting from inflammation in the airways.

Spirometry test to measure lung function.


The low profile brings problems. There is much less focus on COPD compared to other health issues when it comes to securing attention and investment from policy makers. It is more common and carries a higher health burden than diabetes, for example, but receives less funding.

Still, Hurst is optimistic that greater awareness of the clinical symptoms and recognition of the impact the condition has on patients could improve the situation. Countries need to develop an action plan, he says, and to set targets. And one way to help make that happen is for healthcare professionals and patient groups to unite. “Standing together, talking about the same aspects, lobbying for the same things and not pulling in different directions,” he says. “I think we’re starting to see that happen but there need to be more public awareness campaigns.”

One important gain of increased public awareness could be earlier diagnosis. Professor Daiana Stolz of the University Medical Center Freiburg, Germany says the lung function tests typically used to detect COPD are underutilised and only usually find it when it has already significantly progressed.

“The problem is that the lung has a very large reserve,” she says. “You can lose lung function without really noticing it. So the disease gets diagnosed too late.” She states that computer tomography (CT) scans could be a complementary approach. While these are expensive, some of the costs could be absorbed by combining checks for COPD with screening programmes for lung cancer.

“We need people to be aware that COPD is preventable and treatable. And we need governments, patients, industry and physicians to really invest in new therapies that will not only mitigate symptoms but also stop progression of the disease and reverse the pathophysiological mechanisms that cause it,” Stolz says.

She adds: “If we compare it to diabetes, we don’t wait for patients with chronic diabetes who have developed kidney disease to lose a kidney before we treat the disease. The same has to be implemented for COPD. We have to start acting before the organ is destroyed.”

Hurst says he looks “with a certain degree of admiration if not envy” at the advances in other clinical areas: “I think HIV is a good example: there was a concerted public awareness campaign associated with research funding and it has transformed outcomes for HIV and AIDS.”

The lack of progress does at least mean there is plenty of room for improvement. “I think by looking at what others have achieved and how they have done it, the opportunities for COPD are there,” he says.

Veeva ID: Z4-39637 Date of Preparation: November 2021 

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