The national COPD screening programme in China: rationale and design

Background COPD is the most prevalent chronic respiratory disease in China. It is estimated that there is a large, as-yet undetected, high-risk population who will develop in COPD in future. Methods and design In this context, a nationwide COPD screening programme was launched on 9 October 2021. This multistage sequential screening programme incorporates a previously validated questionnaire (i.e. COPD Screening Questionnaire) and pre- and post-bronchodilator spirometry to target the COPD high-risk population. The programme plans to recruit 800 000 participants (eligible age 35–75 years) from 160 districts or counties of 31 provinces, autonomous regions or municipalities across China. The filtered COPD high-risk population and early-detected COPD patients will receive integrated management and be followed-up for ≥1 year. Discussion This is the first large-scale prospective study to determine the net benefit of mass screening for COPD in China. Whether the smoking cessation rate, morbidity, mortality and health status of individuals at high risk of COPD could be improved along with this systematic screening programme will be observed and validated. Moreover, the diagnostic accuracy, cost-effectiveness and superiority of the screening programme will also be assessed and discussed. The programme marks a remarkable achievement in the management of chronic respiratory disease in China. The national COPD screening programme is the first large-scale prospective study to determine the net benefit of mass screening for COPD in China. The programme aims for remarkable achievements in management of chronic respiratory disease in China. https://bit.ly/3Hi475g

[1]  T. Bärnighausen,et al.  Strengthening population medicine to promote public health , 2022, Chinese medical journal.

[2]  Tumaini R. Coker,et al.  Screening for Chronic Obstructive Pulmonary Disease: US Preventive Services Task Force Reaffirmation Recommendation Statement. , 2022, JAMA.

[3]  F. Ricciardi,et al.  Cost-Accuracy Analysis of Chronic Obstructive Pulmonary Disease Screening in Low- and Middle-Income Countries. , 2022, American journal of respiratory and critical care medicine.

[4]  C. Rhee,et al.  The Effectiveness and Harms of Screening for Chronic Obstructive Pulmonary Disease: An Updated Systematic Review and Meta-Analysis , 2022, Journal of Korean medical science.

[5]  Hongbing Shen,et al.  One-off low-dose CT for lung cancer screening in China: a multicentre, population-based, prospective cohort study. , 2022, The Lancet. Respiratory medicine.

[6]  J. Miranda,et al.  Discriminative Accuracy of Chronic Obstructive Pulmonary Disease Screening Instruments in 3 Low- and Middle-Income Country Settings. , 2022, JAMA.

[7]  P. Venkatesan GOLD report: 2022 update. , 2021, The Lancet. Respiratory medicine.

[8]  A. Turner,et al.  Accuracy and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among primary care patients (≥40 years) in China: a cross-sectional screening test accuracy study: findings from the Breathe Well group , 2021, BMJ Open.

[9]  D. Prabhakaran,et al.  Diagnostic Accuracy of a Two-Stage Sequential Screening Strategy Implemented by Community Health Workers (CHWs) to Identify Individuals with COPD in Rural India , 2021, International journal of chronic obstructive pulmonary disease.

[10]  J. Wedzicha,et al.  From GOLD 0 to Pre-COPD , 2020, American journal of respiratory and critical care medicine.

[11]  R. Wise,et al.  A Novel Case-Finding Instrument for Chronic Obstructive Pulmonary Disease in Low- and Middle-Income Country Settings , 2020, International journal of chronic obstructive pulmonary disease.

[12]  D. Fitzmaurice,et al.  Impact of COPD case finding on clinical care: a prospective analysis of the TargetCOPD trial , 2020, BMJ Open.

[13]  P. V. van Ooijen,et al.  Computed Tomography Screening for Early Lung Cancer, COPD and Cardiovascular Disease in Shanghai: Rationale and Design of a Population-based Comparative Study. , 2020, Academic Radiology.

[14]  Kevin McCarthy,et al.  Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement , 2019, American journal of respiratory and critical care medicine.

[15]  Maarten J. IJzerman,et al.  Screening for Early Lung Cancer, Chronic Obstructive Pulmonary Disease, and Cardiovascular Disease (the Big-3) Using Low-dose Chest Computed Tomography: Current Evidence and Technical Considerations , 2019, Journal of thoracic imaging.

[16]  Jiapan Guo,et al.  Early imaging biomarkers of lung cancer, COPD and coronary artery disease in the general population: rationale and design of the ImaLife (Imaging in Lifelines) Study , 2019, European Journal of Epidemiology.

[17]  W. Labaki,et al.  Improving Detection of Early Chronic Obstructive Pulmonary Disease , 2018, Annals of the American Thoracic Society.

[18]  S. Michie,et al.  Effectiveness-implementation of COPD case finding and self-management action plans in low- and middle-income countries: global excellence in COPD outcomes (GECo) study protocol , 2018, Trials.

[19]  J. Wedzicha,et al.  At the Root: Defining and Halting Progression of Early Chronic Obstructive Pulmonary Disease , 2018, American journal of respiratory and critical care medicine.

[20]  R. Hopkins,et al.  Chronic obstructive pulmonary disease (COPD) and lung cancer screening. , 2018, Translational lung cancer research.

[21]  Yongjian Xu,et al.  Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): a national cross-sectional study , 2018, The Lancet.

[22]  Pei Gao,et al.  Chronic obstructive pulmonary disease in China: a nationwide prevalence study , 2018, The Lancet Respiratory Medicine.

[23]  V. Press,et al.  Screening for Chronic Obstructive Pulmonary Disease. , 2017, JAMA.

[24]  C. Ulrik,et al.  Multicenter study of the COPD-6 screening device: feasible for early detection of chronic obstructive pulmonary disease in primary care? , 2017, International journal of chronic obstructive pulmonary disease.

[25]  Meilan K. Han,et al.  A New Approach for Identifying Patients with Undiagnosed Chronic Obstructive Pulmonary Disease , 2017, American journal of respiratory and critical care medicine.

[26]  M. Studnicka,et al.  Development and validation of the Salzburg COPD-screening questionnaire (SCSQ): a questionnaire development and validation study , 2017, npj Primary Care Respiratory Medicine.

[27]  D. Fitzmaurice,et al.  Targeted case finding for chronic obstructive pulmonary disease versus routine practice in primary care (TargetCOPD): a cluster-randomised controlled trial. , 2016, The Lancet. Respiratory medicine.

[28]  F. Martinez,et al.  Screening, Case-Finding, and Outcomes for Adults With Unrecognized COPD. , 2016, JAMA.

[29]  Elizabeth M. Webber,et al.  Screening for Chronic Obstructive Pulmonary Disease: Evidence Report and Systematic Review for the US Preventive Services Task Force. , 2016, Journal of the American Medical Association (JAMA).

[30]  M. Phipps,et al.  Screening for Chronic Obstructive Pulmonary Disease: US Preventive Services Task Force Recommendation Statement. , 2016, JAMA.

[31]  D. Fitzmaurice,et al.  TargetCOPD: a pragmatic randomised controlled trial of targeted case finding for COPD versus routine practice in primary care: protocol , 2014, BMC Pulmonary Medicine.

[32]  N. Zhong,et al.  Development and validation of a chronic obstructive pulmonary disease screening questionnaire in China. , 2013, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease.

[33]  P. Shekelle,et al.  Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society , 2011, Annals of Internal Medicine.

[34]  P. Frith,et al.  Simplified COPD screening: validation of the PiKo-6® in primary care. , 2011, Primary care respiratory journal : journal of the General Practice Airways Group.

[35]  V. Backer,et al.  Early detection of COPD in primary care -The Copenhagen COPD Screening Project , 2010, BMC public health.

[36]  Anand A. Dalal,et al.  Predicting risk of airflow obstruction in primary care: Validation of the lung function questionnaire (LFQ). , 2010, Respiratory medicine.

[37]  T. van der Molen,et al.  Primary prevention of chronic obstructive pulmonary disease in primary care. , 2009, Proceedings of the American Thoracic Society.

[38]  D. Price,et al.  Screening for and early detection of chronic obstructive pulmonary disease , 2009, The Lancet.

[39]  J. Zieliński,et al.  Prevalence, severity and underdiagnosis of COPD in the primary care setting , 2008, Thorax.

[40]  Anastasia E. Raczek,et al.  Development and Initial Validation of a Self-Scored COPD Population Screener Questionnaire (COPD-PS) , 2008, COPD.

[41]  V. Kinnula,et al.  Chronic bronchitis and chronic obstructive pulmonary disease. The Finnish Action Programme, interim report. , 2007, Respiratory medicine.

[42]  D. Price,et al.  Scoring system and clinical application of COPD diagnostic questionnaires. , 2006, Chest.

[43]  Y Fukuchi,et al.  Increasing COPD awareness , 2006, European Respiratory Journal.

[44]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[45]  R. Pauwels,et al.  Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. , 2001, American journal of respiratory and critical care medicine.

[46]  J. Zieliński,et al.  Early detection of COPD in a high-risk population using spirometric screening. , 2001, Chest.

[47]  O. Balchum Screening for chronic obstructive pulmonary disease. , 1968, Archives of environmental health.

[48]  C. Lenfant,et al.  Global Initiative for chronic obstructive lung disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease , 2006 .