Appropriate diagnosis of COPD can have significant public health impact

NEW YORK, NY – Nov. 19, 2025 – Chronic obstructive pulmonary disease (COPD) is a preventable and treatable condition marked by breathlessness, chronic sputum production and cough, claiming three million lives globally each year —particularly in low-resource countries — and is expected to increase due to aging populations and ongoing exposure to risks like tobacco smoke and air pollution.

In recognition of World COPD Day on Nov. 19, the Forum of International Respiratory Societies (FIRS), of which the American Thoracic Society is a founding member, is highlighting the importance of correctly diagnosing COPD earlier - with the theme “Short of Breath, Think COPD.”  

Although COPD is a common, preventable, and treatable disease, extensive under-diagnosis, misdiagnosis, and late-diagnosis lead to patients receiving no treatment, incorrect treatment, or less effective treatment. Studies from across the world suggest that up to 70 percent of adults with COPD remain undiagnosed, with rates even higher in low and middle-income countries.^(1,2,3) Undiagnosed COPD can lead to greater symptom burden, poor quality of life, impaired work productivity, and poorer overall general health status.⁽⁴⁾

There are many factors that can lead to inappropriate or missed diagnosis, including patient-, healthcare system-, and provider-related factors. Patients may not recognize or report symptoms accurately, healthcare systems may not have resources to adequately train staff in respiratory health, or providers may have a poor understanding of COPD diagnostic criteria.

Health providers should look for the following risk factors:

• Age ≥ 35 years
• Exposure to risk factors (tobacco smoke, household and outdoor air pollution, occupational exposures)
• Genetic factors
• Prematurity and early life disadvantage factors
• Respiratory symptoms.

Accurate and timely diagnosis of COPD can improve quality of life and health outcomes. Based on currently available evidence, GOLD advocates for active case finding, including performing spirometry in individuals with symptoms and/or risk factors.⁽⁵⁾

Although there is currently no cure for COPD, steps to help improve diagnosis can have a positive impact on future health. Medications like bronchodilators as well as exercise and pulmonary rehabilitation can help  Patients and families can help advocate for more research and better access to care, including routine spirometry screenings and telehealth access for patients in remote settings.  In addition, providers and policy makers can work together to improve access to spirometry and advocate for its use as a general health marker in all stages of life. Health systems can work to increase academic training programs specializing in respiratory health, as well as improve training in COPD diagnostic criteria, including the use and interpretation of spirometry.

Learn more in the 2026 GOLD Report: GLOBAL STRATEGY FOR THE DIAGNOSIS, MANAGEMENT, AND PREENTION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (2026 REPORT).

The ATS Breathe Easy podcast highlights exercise in managing COPD in the Nov. 18 episode. Our guests Rachel Evans, MD, University of Leicester, and Russell Winwood, a patient advocate, join host Amy Attaway, MD. We continue the COPD conversation on Nov. 25 with pulmonologist Meilan Han, MD, MS, who discusses the non-smoking causes of COPD with host Erika Moseson, MD, MS.

World COPD Day World COPD Day is an annual global initiative run by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), a member of the Forum of International Respiratory Societies (FIRS). The goal of World COPD Day is to raise awareness and present new knowledge and therapeutic strategies for COPD worldwide.  The 23rd annual World COPD Day will take place on Nov. 20, 2024. 

Be part of the global effort to improve the lives of people with COPD. Join World COPD Day events organized by GOLD and FIRS. Find out more here.

For more information about FIRS please contact Helen Dugdale at helen.dugdale@firsnet.org.

1. Lytras T, Kogevinas M, Kromhout H, et al. Occupational exposures and 20-year incidence of COPD: the European Community Respiratory Health Survey. Thorax 2018; 73(11): 1008-15 https://pubmed.ncbi.nlm.nih.gov/29574416.
2. Lamprecht B, Soriano JB, Studnicka M, et al. Determinants of Underdiagnosis of COPD in National and International Surveys. Chest 2015; 148(4): 971-85
3. Martinez CH, Mannino DM, Jaimes FA, et al. Undiagnosed Obstructive Lung Disease in the United States. Associated Factors and Long-term Mortality. Annals of the American Thoracic Society 2015; 12(12): 1788-95
4. Labonté LE, Tan WC, Li PZ, et al. Undiagnosed Chronic Obstructive Pulmonary Disease Contributes to the Burden of Health Care Use. Data from the CanCOLD Study. American Journal of Respiratory and Critical Care Medicine 2016; 194(3): 285-98
5. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for Prevention, Diagnosis and Management of COPD: 2026 Report. 2026 GOLD Report and Pocket Guide - Global Initiative for Chronic Obstructive Lung Disease - GOLD