Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort
Abstract Background The burden of undiagnosed obstructive lung disease (OLD) (mainly asthma and chronic obstructive pulmonary disease) is not fully established, and targets for corrective action are yet to be identified. We assessed the underdiagnosis of OLD and its determinants in France. Methods C...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-021-01688-z |
| _version_ | 1818724714332291072 |
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| author | Marie-Christine Delmas Laetitia Bénézet Céline Ribet Yuriko Iwatsubo Marie Zins Rachel Nadif Nicolas Roche Bénédicte Leynaert |
| author_facet | Marie-Christine Delmas Laetitia Bénézet Céline Ribet Yuriko Iwatsubo Marie Zins Rachel Nadif Nicolas Roche Bénédicte Leynaert |
| author_sort | Marie-Christine Delmas |
| collection | DOAJ |
| description | Abstract Background The burden of undiagnosed obstructive lung disease (OLD) (mainly asthma and chronic obstructive pulmonary disease) is not fully established, and targets for corrective action are yet to be identified. We assessed the underdiagnosis of OLD and its determinants in France. Methods CONSTANCES is a French population-based cohort of adults aged 18–69 years at inception. We analysed data collected at inclusion in 2013–2014. Undiagnosed OLD was defined as spirometry-confirmed airflow limitation (FEV1/FVC < lower limit of normal) without prior diagnosis of asthma, chronic obstructive pulmonary disease, or bronchiectasis. Multivariate analysis was performed with weighted robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of undiagnosed OLD. Results Spirometry results were available for 19,398 participants. The prevalence of airflow limitation was 4.6%. Overall, 64.4% of adults with airflow limitation did not report a previous diagnosis of OLD. Individuals with high cumulative tobacco consumption (≥ 10 pack-years) (aPR: 1.72 [1.28–2.32]), without respiratory symptoms (aPR: 1.51 [1.28–1.78]), and with preserved lung function (aPR: 1.21 [1.04–1.41] for a 10-point increase in FEV1% predicted) had a higher risk of being undiagnosed. Half of symptomatic individuals with airflow limitation (45% of those with moderate to severe airflow limitation) were undiagnosed with OLD. Conclusion Underdiagnosis of OLD is very common among French adults, even in patients with respiratory symptoms. Efforts should be made in France to raise awareness about OLD in the general population, improve the detection of respiratory symptoms, and increase the use of spirometry among primary care professionals. |
| first_indexed | 2024-12-17T21:30:48Z |
| format | Article |
| id | doaj.art-7428dc03486247dd9bb23e8642f05e44 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-17T21:30:48Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-7428dc03486247dd9bb23e8642f05e442022-12-21T21:31:53ZengBMCBMC Pulmonary Medicine1471-24662021-10-0121111010.1186/s12890-021-01688-zUnderdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohortMarie-Christine Delmas0Laetitia Bénézet1Céline Ribet2Yuriko Iwatsubo3Marie Zins4Rachel Nadif5Nicolas Roche6Bénédicte Leynaert7Santé Publique France, French National Public Health AgencySanté Publique France, French National Public Health AgencyInserm UMS 011, Population-Based Epidemiological CohortsSanté Publique France, French National Public Health AgencyInserm UMS 011, Population-Based Epidemiological CohortsInserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, Université Paris-Saclay, UVSQ, Université Paris-SudInserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, Université Paris-Saclay, UVSQ, Université Paris-SudInserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, Université Paris-Saclay, UVSQ, Université Paris-SudAbstract Background The burden of undiagnosed obstructive lung disease (OLD) (mainly asthma and chronic obstructive pulmonary disease) is not fully established, and targets for corrective action are yet to be identified. We assessed the underdiagnosis of OLD and its determinants in France. Methods CONSTANCES is a French population-based cohort of adults aged 18–69 years at inception. We analysed data collected at inclusion in 2013–2014. Undiagnosed OLD was defined as spirometry-confirmed airflow limitation (FEV1/FVC < lower limit of normal) without prior diagnosis of asthma, chronic obstructive pulmonary disease, or bronchiectasis. Multivariate analysis was performed with weighted robust Poisson regression models to estimate the adjusted prevalence ratios (aPR) of undiagnosed OLD. Results Spirometry results were available for 19,398 participants. The prevalence of airflow limitation was 4.6%. Overall, 64.4% of adults with airflow limitation did not report a previous diagnosis of OLD. Individuals with high cumulative tobacco consumption (≥ 10 pack-years) (aPR: 1.72 [1.28–2.32]), without respiratory symptoms (aPR: 1.51 [1.28–1.78]), and with preserved lung function (aPR: 1.21 [1.04–1.41] for a 10-point increase in FEV1% predicted) had a higher risk of being undiagnosed. Half of symptomatic individuals with airflow limitation (45% of those with moderate to severe airflow limitation) were undiagnosed with OLD. Conclusion Underdiagnosis of OLD is very common among French adults, even in patients with respiratory symptoms. Efforts should be made in France to raise awareness about OLD in the general population, improve the detection of respiratory symptoms, and increase the use of spirometry among primary care professionals.https://doi.org/10.1186/s12890-021-01688-zObstructive lung diseaseUnderdiagnosisCOPDAsthmaFrance |
| spellingShingle | Marie-Christine Delmas Laetitia Bénézet Céline Ribet Yuriko Iwatsubo Marie Zins Rachel Nadif Nicolas Roche Bénédicte Leynaert Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort BMC Pulmonary Medicine Obstructive lung disease Underdiagnosis COPD Asthma France |
| title | Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort |
| title_full | Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort |
| title_fullStr | Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort |
| title_full_unstemmed | Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort |
| title_short | Underdiagnosis of obstructive lung disease: findings from the French CONSTANCES cohort |
| title_sort | underdiagnosis of obstructive lung disease findings from the french constances cohort |
| topic | Obstructive lung disease Underdiagnosis COPD Asthma France |
| url | https://doi.org/10.1186/s12890-021-01688-z |
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