COPD Stages

If you have chronic obstructive pulmonary disorder (COPD), your doctor may have told you which stage you are in. Doctors use COPD stages to determine treatment and track how the disease is progressing. This means they track the amount of permanent damage that has already happened inside your lungs and how severe that damage is.1,2

Your COPD stage may also be called a COPD grade or GOLD stage. This is named after the Global Initiative for Chronic Obstructive Lung Disease (GOLD). You may also be given a letter, called your COPD group.1,3

The first step in identifying a person’s COPD stage is taking breathing tests called spirometry tests. These tests measure how well your lungs are working.3

Your doctor may also consider other factors when determining the stage, such as how often you have flare-ups, or exacerbations. You may be asked to fill in a questionnaire like the COPD Assessment Test (CAT) or modified Medical Research Council test (mMRC). Your doctor will use these results and the results of your spirometry tests to determine your stage.3

What are the 4 stages of COPD?

There are 4 possible stages, or grades, of COPD:1

  • Stage I: Mild COPD
  • Stage II: Moderate COPD
  • Stage III: Severe COPD
  • Stage IV: Very Severe COPD

Stage I COPD

Mild COPD means the lungs already have a small amount of damage but the disease has not progressed very far yet. Some people with stage I COPD may not even notice that their lungs are not working as well. Other people might have shortness of breath during exercise or other kinds of physical activity.1,3

Stage II COPD

In stage II COPD, the disease has progressed further. The person usually starts to experience symptoms more often than they did in Stage I.1,3

Stages III and IV COPD

In stages III and IV, a person usually has symptoms that are much more serious and happen more often. They will also have more serious flare-ups.1,3

COPD groups

Your COPD also may be identified with a letter, called a group. This is a newer identification method that GOLD introduced and is less commonly used. This letter describes your symptoms and risk. The meanings include:1,3

  • Group A: Lower risk, fewer symptoms
  • Group B: Lower risk, more symptoms
  • Group C: Higher risk, fewer symptoms
  • Group D: Higher risk, more symptoms

Why is it important to find out your COPD stage?

Your COPD stage gives your doctors an understanding of your specific case and how best to treat you. The different stages of COPD require different types of treatment strategies. The right kind of treatment allows people with COPD better control their symptoms. Each person's unique treatment plan includes advice about lifestyle changes, medicines, or breathing therapy options that are best for that stage of the disease.1,3

Your stage also gives your doctors the ability to track disease progression. By knowing your COPD stage at the beginning of treatment, they can track changes to the disease. This helps to show if a treatment plan has been effective. Testing your COPD stage again after you have been treated for a while can show how well the treatment is working.1,3

If the COPD stage has stayed the same between 2 tests, it means your disease has not gotten worse. This usually means the treatment plan is helping. In some cases, the next test might show that your COPD stage has gotten worse. If this happens, it is a sign that your doctor may need to change your treatment plan to better manage your condition.1,3

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Written by: Juliette Daily | Last reviewed: July 2021.