• Yuko Komase, Tadashi Abe, Keita Kasahara, Takeshi Kaneko, Hiroshi Takahashi, Masanori Nishikawa, and Ichiro Kuwahira.
• St. Marianna University School of Medicine, Yokohama-City Seibu Hospital, Yokohama. yukomase@marianna-u.ac.jp
• Intern. Med. 2008 Jan 1;47(20):1791-6.

ObjectiveSince mild COPD can be detected in the annual health check by lung function tests, we conducted a questionnaire survey on how such examinations are used to assess chronic obstructive pulmonary disease (COPD).MethodsWe mailed questionnaires to 633 facilities performing comprehensive medical check-up from June to July 2005 and obtained responses from 254 (40.1%).ResultsAt participating facilities, the proportion of full or part-time physicians specializing in respiratory diseases was low [40 of 366 full timers (10.9%) and 114 of 2,044 part-timers (5.6%)], with very few physicians certified by the Japanese Respiratory Society (6.8%). Non respiratory physicians were involved in evaluating the results of thoracic diagnostic imaging at 32 facilities. Lung function tests were carried out at 98.2% of facilities though relatively few facilities evaluated test results with COPD in mind. All stages (mild, moderate, severe) of COPD were diagnosed in patients at 85 facilities (39.2%), while only severe COPD was targeted by chest imaging at 97 facilities (44.7%), disregarding mild and moderate cases. Counseling for smoking cessation was provided at 113 facilities (20.6%), while 30 facilities (14.4%) provided no form of smoking cessation.ConclusionAt most facilities performing a comprehensive medical check-up, there was not a sufficient number of respirologists to ensure early diagnosis of COPD and this may have compromised COPD diagnosis. The newly proposed Japan Society of Comprehensive Medical Check-up (Ningen-dock) Standards based on the Japanese Respiratory Society may be useful to reveal early stages of COPD.

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