Preventing chronic obstructive pulmonary disease: what is known and what needs to be done to make a difference to the patient?

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable systemic disease with symptoms that overlap other respiratory illnesses. An estimated 24 million adults in the United States have COPD, but >50% of them are misdiagnosed or undiagnosed. Spirometry remains the "gold standard" for diagnosing COPD and for monitoring the progression of the disease. Cigarette smoking is the main cause of COPD; therefore, smoking cessation is an integral component of any program to reduce COPD risk and delay or limit the progression of airflow obstruction. Influenza vaccinations will also reduce acute respiratory illness in patients with COPD. With increasing awareness of COPD and earlier diagnosis, implementation of treatment guidelines and smoking-cessation efforts may lead to more effective management of this disease, which is projected to be the third leading cause of death in the United States by 2020.