Updated GOLD report presents new understandings in diagnosis, treatment and preventi...(e necessary for the coordinated treatmen...),Health

Unfortunately, despite the significant progress that has been made in the understanding and management of the disease, the behavioral and cultural factors that have pushed the disease into the top-five list of killer diseases worldwide remain largely unchanged.

Cigarette smoking and secondhand smoke exposure are the most commonly encountered risk factors for COPD in the developed world. In developing countries, COPD arises primarily from long-term exposure to smoke from biomass fuel used for indoor cooking and heating. Women, who began smoking in higher numbers after World War II, and who bear the brunt of indoor exposures in developing countries, are now more likely to die of the disease than men. Furthermore, because COPD generally develops over a period of decades, the current rise in cases is unlikely to abate soon.

The prevalence and burden of COPD are projected to increase in the coming decades due to continued exposure to COPD risk factors and the changing age structure of the worlds population, wrote the researchers.

While the new guidelines represent a significant step toward more comprehensive treatment and understanding of COPD, they are also a work in progress. Continuous updates of the literature provide the opportunity to identify areas of weakness, noted Leonardo M. Fabbri, M.D., who wrote an editorial on the report in the same issue of the journal. As examples, he cited areas of COPD research that require more investigation and further refinement, including the need to improve methods for determining the severity of the disease, and developing a more comprehensive approach to assessing co-morbidities.

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