Public screening for lung disease: experience with the NIH Lung Health Study.

The Lung Health Study is the first major initiative of the National Heart, Lung, and Blood Institute in screening for and intervention in early lung disease. The objective of the study is to identify cigarette smokers who have early disease and determine whether an intervention program of smoking cessation and bronchodilator therapy will alter the course of their disease. After an extensive screening program, 5,887 participants have been randomized to one of three groups: usual care, intervention with smoking cessation and the use of a placebo inhaler, and intervention with smoking cessation and the use of ipratropium bromide. All participants will be followed for 5 years. Preliminary data from the screening indicate that chronic obstructive pulmonary disease is more prevalent than was previously recognized, that it is widespread in women as well as men, and that it is far more common in young individuals than was thought. Approximately two-thirds of the study participants have hyperreactive airways. Preliminary data from the Lung Health Study indicate that screening for lung function can be carried out in a cost-effective manner.