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Do the ‘missing millions’ of COPD patients want to be found?
  1. David MG Halpin1,2
  1. 1 University of Exeter Medical School, Exeter, UK
  2. 2 Royal Devon and Exeter Hospital, Exeter, UK
  1. Correspondence to Professor David MG Halpin, University of Exeter Medical School, Exeter, EX1 2HZ, UK; d.halpin{at}

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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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  • Contributors DMGH is the sole author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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