Rising COPD rates in women contradict disease perceptions

The American Lung Assn. calls for funding for more gender-specific research and for physicians always to use spirometry to make a diagnosis.

By — Posted June 17, 2013

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When a woman enters an exam room complaining of breathing problems, physicians need to make sure they consider chronic obstructive pulmonary disease as a possible diagnosis, a new report suggests.

More than half of the 120,000 COPD deaths in the U.S. each year are women, making it the third-leading cause of death for the gender, according to the American Lung Assn.'s “Taking Her Breath Away: The Rise of COPD in Women,” released June 5. The disease kills more women in a year than breast cancer and diabetes combined.

And women are now 37% more likely then men to have COPD, according to the report. Years ago, that wasn't the case.

“We tend to have a perception of COPD as being an old man's disease, but I think that perception is changing,” said MeiLan Han, MD, medical director for the Women's Respiratory Health Program at the University of Michigan and national spokeswoman for the American Lung Assn.'s report.

Elevated risk

The paper notes that women are more susceptible to lung damage. “Female lungs and airways are smaller than men's and have less respiratory muscle to move air in and out,” according to the report. “As a result, cigarette smoke and other lung irritants get more concentrated when they are inhaled and can cause more damage.

“The fact that women with COPD are 1.5 times more likely to have never smoked than men with COPD is a good indication that they are also at greater risk from other causes of the disease, such as secondhand smoke, harmful workplace exposures and outdoor air pollution.”

More than 7 million women have COPD, and millions more have yet to be diagnosed, Dr. Han said. It is critical that a patient undergoes a spirometry test to confirm the diagnosis, she said. Studies have shown that only about a third of patients have had the diagnosis confirmed with that tool.

“Spirometry is easy, and it is not expensive,” Dr. Han said. Without it, some patients may end up with an incorrect diagnosis for something such as asthma instead of COPD; other patients may have a COPD diagnosis and not actually have the disease, she said.

When physicians diagnose patients with COPD, they should refer them to pulmonary rehabilitation programs to learn more general information about the disease, techniques to breathe more easily and methods of using an inhaler, according to the report.

“Pulmonary rehabilitation is an excellent resource for women,” Dr. Han said. Yet the report found that only about 2% of COPD patients have access to a rehab program.

The American Lung Assn. wants the government and health care leaders at the national, state and local levels to “embrace a sense of urgency and a can-do attitude about COPD.” The association is calling for:

COPD kills more women every year than breast cancer and diabetes combined.

  • Strengthening the public health response, including the Centers for Disease Control and Prevention creating and supporting a program similar to what is in place for other major health problems and the states collecting more standardized COPD-related data to better track it and allocate resources.
  • Increasing investment in gender-specific research.
  • Expanding efforts to protect everyone from harmful exposures that cause COPD, such as discouraging youth from smoking, protecting people from secondhand smoke and reducing outdoor air pollution.
  • Implementing health care systems changes to improve the timeliness and quality of COPD care, such as using spirometry more frequently.
  • Breaking the silence by having women's health advocates and women living with COPD speak out about the disease and how it affects women's lives.

“Leadership in public health and health care at the national, state and local levels must urgently confront this deep-rooted and deadly disease head on,” Dr. Han said.

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External links

“Taking Her Breath Away: The Rise of COPD in Women,” American Lung Assn., June (link)

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