A second data analysis of the CARDIA (Coronary Artery Risk Development In Young Adults) lung study found that emphysema can often be detected on a CT scan before spirometry results are negative. The results of the study show that relying on spirometry alone can lead to a lack of understanding of respiratory health. Because the disparity is particularly prevalent among black men, this can add to the stigma. Research is published in Annals of Internal Medicine.
Spirometry is used to measure COPD, but over-reliance on spirometry can miss early signs of COPD and respiratory illness. Recent studies have shown that gender-specific interpretations of spirometry may predict the severity of respiratory symptoms and risk of death in Blacks.
Researchers from the Northwestern University Feinberg School of Medicine conducted a second study of the CARDIA lung study to determine the difference in the prevalence of emphysema between Black and White adults with normal spirometry results. The study included 2,674 participants who received both computed tomography (CT) and spirometry.
The authors found that a significant proportion of middle-aged adults with “normal” spirometry findings based on gender stratification had emphysema on CT, and the trend was not consistent among black men even after adjustment for years and smoking. The use of inter-racial criteria to interpret spirometry reduced the racial difference in the prevalence of emphysema among those with “normal” results but did not eliminate it. According to the authors, these findings suggest that gender-specific interpretations of spirometry may be masking racial disparities in respiratory health rather than identifying actual biological differences in lung function.
Gabrielle Y. Liu et al, Comparison of Ethnic Differences in the Prevalence of Emphysema Among Adults with Normal Lungs: A Secondary Data Analysis of the CARDIA Lung Study, Annals of Internal Medicine (2022). DOI: 10.7326/M22-0205
American College of Physicians
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