Chronic Obstructive Pulmonary Disease, or COPD, is one of the most common lung conditions in the world—yet it remains deeply underdiagnosed. In the United States alone, over 12.5 million people are known to have COPD, but millions more may be living with it. One of the main reasons for this gap is that early symptoms, such as a lingering cough or shortness of breath, are often easily dismissed. Many people don’t seek help until their breathing problems are severe and irreversible damage has already taken place.
Detecting COPD in its early stages opens the door to a range of treatments, lifestyle changes, and support systems that can dramatically improve quality of life. More importantly, it can slow the progression of lung damage, reduce the risk of complications, and help people maintain their independence for a longer period.
What is COPD
COPD is a chronic condition that makes it harder to move air in and out of the lungs. It includes both emphysema, which damages the air sacs in the lungs, and chronic bronchitis, which causes long-term inflammation of the airways. Many people initially attribute early symptoms to aging, seasonal allergies, or being out of shape. These symptoms can include a chronic cough, shortness of breath during activity, wheezing, frequent respiratory infections, and fatigue.
Why It Is Important to Diagnose Early
Early diagnosis is critical because COPD causes progressive and permanent damage to lung tissue. Once lung function is lost, it cannot be regained. COPD also takes a heavy emotional and financial toll. The condition often leads to anxiety, depression, and disability, and its impact on work and productivity can be devastating for individuals and families. According to the American Lung Association, the total annual economic burden of COPD in the U.S. is nearly $50 billion, including direct healthcare costs and the indirect costs of lost work and early death.
Fortunately, when COPD is diagnosed early, there are more options to intervene. For many people, quitting smoking is the most important step they can take. Pulmonary rehabilitation programs, which combine exercise, education, nutrition, and support, can help improve lung function and reduce symptoms. Medications such as bronchodilators, steroids, and antibiotics (when infections occur) can also slow progression, along with vaccinations to prevent pneumonia and flu. In some cases, supplemental oxygen or non-invasive ventilation (using a mask at home to help support breathing) can significantly improve quality of life and reduce the need for hospital visits.
Open surgical procedures, such as lung transplants or lung volume reduction surgery, can benefit some patients; however, many are not candidates due to the associated risks and complications. That’s why newer, less invasive procedures are gaining attention. One such option is endobronchial valve (EBV) therapy, a minimally invasive treatment in which a one-way valve is placed in the airways to allow trapped air to escape. Though not a cure, EBV therapy can reduce lung hyperinflation, improve breathing, and enhance daily function without the need for traditional surgery.
How COPD is Diagnosed
COPD has historically been diagnosed using spirometry, a breathing test that measures the volume of air a person can exhale and the rate at which it is exhaled. However, this approach has limitations. Many people, especially in the early stages of the disease, may have normal spirometry results despite ongoing lung damage. For decades, the focus of screening has been only on smokers. We now know that COPD can also develop in people exposed to secondhand smoke, air pollution, recurring childhood respiratory infections, or inherited genetic conditions like alpha-1 antitrypsin deficiency.
Women, in particular, have been underdiagnosed for years. Today, more women than men are diagnosed with COPD in the United States, and they are more likely to die from the disease. Several factors may contribute to this. Women tend to have smaller lungs and airways, which means harmful particles from smoke or pollution may have a more concentrated effect. Research suggests that women often develop COPD at a younger age and with less smoking exposure than men. Hormones, such as estrogen, may also influence how the lungs respond to inflammation and injury over a lifetime. In many countries, especially in developing regions, women are also more likely to be exposed to indoor air pollution from cooking fuels, compounding their risk.
In recent years, advances in imaging technology have transformed the way we detect lung disease. Low-dose CT (LDCT) scans, initially developed for lung cancer screening, can now identify early signs of emphysema. These scans can reveal damage in people who feel completely healthy, creating an opportunity to act before the disease progresses. In an extensive study of more than 50,000 individuals, nearly one in four had emphysema visible on LDCT despite having no prior diagnosis of COPD. Many of these cases were moderate to severe in nature. These findings suggest that integrating emphysema assessment into lung cancer screening programs, especially for high-risk or underserved populations, could be a game-changer for early detection.
Clinicians are increasingly encouraged to look beyond smoking history when evaluating a person’s risk for lung disease. Personalized risk assessments should also consider exposure to secondhand smoke, environmental or occupational hazards, and a family history of lung conditions. By broadening our understanding of who is at risk, we can catch more cases early and improve outcomes.
Expanding Access to Early Diagnosis
New technology is also playing an exciting role in expanding access to early diagnosis. Olympus recently announced the launch of SeleCT™ Screening, an artificial intelligence (AI)-powered platform developed in partnership with 4DMedical. This system automatically reviews existing chest CT scans in hospital systems to identify signs of severe emphysema. Physicians are alerted to consider bronchoscopic lung volume reduction (BLVR) when a potential candidate is found. This type of automation can significantly speed up the path from detection to treatment.
Another innovation comes from 4DMedical’s CT: VQ software, which can create detailed lung function maps from a standard, non-contrast CT scan, without the need for dyes or radioactive tracers. COPD affects not just airflow, but also blood flow in the lungs. By analyzing changes in lung tissue motion and density during breathing, this technology provides high-resolution, quantitative data on both ventilation and perfusion. It also overcomes many of the limitations of traditional nuclear medicine scans, making it easier to assess lung function across healthcare settings.
COPD doesn’t start when you’re diagnosed; it begins years earlier, quietly damaging the lungs. The sooner it’s caught, the more we can do to slow it down, manage symptoms, and help people live whole and active lives.