The Forum of International Respiratory Societies highlights the importance of correctly diagnosing COPD earlier – with the theme ‘Short of Breath, Think COPD’

19 November, 2025

In support of World COPD Day on November 19, the Forum of International Respiratory Societies (FIRS), of which the European Respiratory Society (ERS) is a founding member, is highlighting the importance of correctly diagnosing COPD earlier – with the theme ‘Short of Breath, Think COPD’.

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.

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% 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 recognise 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.

It’s important for health providers to look for the following risk factors:

• Age ≥ 35 years
• Exposure to risk factors (tobacco smoke, household and outdoor air pollutions, 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. 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 specialising 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.

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