Finding the ‘missing millions’ of patients with COPD has become a mantra of health policy. In the UK, 1.4 million people have a diagnosis of COPD but it is estimated that 50%–65% of people living with COPD are undiagnosed. This has been made worse by the COVID pandemic when new diagnosis rates fell by over half. In a recent survey of patients with COPD, 22% reported waiting 5 years or more for a diagnosis after noticing symptoms.1 In many cases, they had problems accessing diagnostic testing with spirometry; however, one in three said it was because they had waited a year or more before seeking help. The report concluded that getting a diagnosis, was ‘often the culmination of a protracted period of deteriorating symptoms and missed opportunities’.1 Case finding among high-risk groups to identify COPD is recommended2 3 and adding spirometry to lung health checks (LHC) in current or ex-smokers seems an obvious way of finding some of the missing millions. In this issue, Bradley et al report their experience of Incorporating pre-bronchodilator spirometry into LHC with low-dose CT screening for lung cancer in Yorkshire.4 Although uptake of the screening programme itself was low, most people who did participate agreed to perform spirometry. A total …

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是否希望找到“失踪的数百万”COPD 患者？

寻找“失踪的数百万”COPD 患者已成为卫生政策的口头禅。在英国，有 140 万人被诊断患有 COPD，但据估计，有 50%–65% 的 COPD 患者未被确诊。当新诊断率下降一半以上时，COVID 大流行使情况变得更糟。在最近一项针对 COPD 患者的调查中，22% 的患者表示在注意到症状后要等待 5 年或更长时间才能得到诊断。1 在许多情况下，他们无法通过肺量计进行诊断测试；然而，三分之一的人表示，这是因为他们等了一年或更长时间才寻求帮助。该报告的结论是，获得诊断“通常是长期恶化症状和错失良机的结果”。1 建议在高危人群中发现病例以识别 COPD2 3 并且将肺活量测定法添加到当前或戒烟者的肺部健康检查 (LHC) 中似乎是找到数百万失踪者中的一些人的明显方法。在本期杂志中，Bradley 等人报告了他们在约克郡将支气管扩张剂前肺活量测定纳入 LHC 和低剂量 CT 肺癌筛查的经验。 4 尽管筛查计划本身的接受度很低，但大多数参与的人都同意进行肺活量测定. 一共…… 大多数参与的人都同意进行肺活量测定。一共…… 大多数参与的人都同意进行肺活量测定。一共……