The Early Stages Of COPD: What To Know

A majority of people with COPD are in the early stages of the disease.^1-3 And they probably don’t even know it. Here’s what to know.

What is early stage COPD?

The Global Initiative for Obstructive Lung Disease (GOLD) COPD Guidelines suggest that there are four stages of COPD. The first two stages are generally considered the early stages. These are also often referred to as mild and moderate COPD.

• Stage 1: Mild: FEV1 >80%
• Stage 2: Moderate: FEV1 51% to 79%¹

Studies were performed in various countries using FEV1 to measure disease severity. According to these studies, 25-57% of COPDers had mild COPD and 25-51% had moderate COPD. So, at least according to these studies, a majority of COPDers are in the early stages.¹

I explain FEV1 in my post, “What Is Pulmonary Function Testing?”

Keep in mind that rare is it that people in these early stages require hospitalizations. So, as a respiratory therapist, rarely will I meet you when you are in the early stages. Deaths due to COPD are rare in these early stages as well. Most people in these early stages can live a normal, functioning life.³

So, what does this mean?

Well, it’s never fun to be diagnosed with a lung disease, or any disease for that matter.

At this stage, mild changes have occurred inside your lungs. You may feel no symptoms at all. But, you may feel some shortness of breath. You may feel easily tired when you exert yourself. You may have a sometimes cough. You may have some increase amounts of mucus produced when you a cough. You may have some chest tightness or pain.^2-4

But, most people are diagnosed between stages 2-4.⁴  It’s better to be diagnosed in these early stages than in the later stages (or stages 3 and 4).

So, in an odd way, this is good news. Why? Because COPD is a progressive disease. When diagnosed early and treated aggressively, this progression can be slowed. You can go on to live a long, quality life despite this diagnosis.^1-4

What roadblocks are in the way here?

The problem here is that these symptoms may be mild in these early stages. They may progress so gradually that they are brushed off as due to aging.  For these and other reasons, COPD in the early stages often goes undiagnosed.^1-2,4

One study showed that only 22% of COPDers in the early stages was properly diagnosed with COPD. Ten years later, this percentage only increased to 27%. Other studies showed similar results. So, researchers claim that 45-85% of COPDers are undiagnosed.¹

So, when undiagnosed, it also goes untreated. This is sad because the earlier it’s treated, the better your chances are of getting proper education and treatment needed to slow the progression of the disease.²

Also quite interesting, is that one study showed that over a third of current or former smokers diagnosed with COPD reported no symptoms. Likewise, over a third of people who never smoked and were diagnosed with COPD experienced no symptoms.³

Some people are diagnosed in these early stages. Of those diagnosed who smoke, many are encouraged to quit smoking. But, one study showed that only 5% of these individuals quit smoking.³

So, these studies may further highlight the need to develop some kind of screening criteria that doesn’t involve symptoms monitoring. It may also highlight a need to come up with improved awareness and educational strategies for those in these early stages.³

What to make of this?

So, these studies indicate that better screening criteria definitely need to be created to help physicians diagnose these patients. This is something that may need to be further studied. It’s also something that may need to be addressed in future COPD guidelines.

But, many of these people with undiagnosed COPD may not seek medical attention. But that’s exactly what they need to do. So, efforts need to be done to educate this group of patients. But, how can this be accomplished? At the present time, the answer to this question remains unknown.