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Back Importance of early recognition Although COPD is a common condition, many people remain undiagnosed. Symptoms often develop gradually, and people may not realise they have the disease until it has reached a more advanced stage. This delay in diagnosis is frequently due to the slow progression of symptoms, which are sometimes attributed to aging or long-term smoking. Some people may also hesitate to seek medical help because they feel guilty about smoking. Another reason could be that the GP does not initially link the symptoms to COPD, as they can resemble those of other conditions. As a result, spirometry — which is essential for confirming COPD — may be postponed, further delaying diagnosis. Knowing the early warning signs of COPD is important, especially if you’re at higher risk of developing COPD (see our module on Symptoms). The earlier COPD is diagnosed, the sooner treatment can begin, which will help slow down lung damage. If you notice any symptoms, talk to your healthcare provider. On this page, you’ll learn how COPD is diagnosed, what tests may be used for diagnosis, and how COPD is classified into different stages. How is COPD diagnosed? To diagnose COPD, your healthcare provider will ask you a range of questions, perform a physical exam, and offer specific tests to diagnose the condition. Depending on the availability of the materials in their office, your provider might also refer you to a specialist for further testing. Your GP may ask you questions such as: What symptoms you experience, what seems to trigger them (for example, physical activity or respiratory infections), and how long you’ve had them. You may also be asked how often your symptoms have worsened and how these flare-ups were treated in the past, especially if this was managed by a different healthcare provider. Whether your symptoms change from day to day How your symptoms affect your daily life Whether you have risk factors for COPD, such as smoking or exposure to dust and fumes at work Your medical history, including frequent chest infections or allergic conditions like hay fever, eczema, or asthma Whether close family members have COPD, other lung conditions or liver disease Any hospital visits you’ve had for breathing problems To feel optimally prepared for your first consultation, check out our PDF guide here. If your doctor thinks you might have COPD, a few tests might be proposed, which can be broadly divided into three big groups: lung function tests, imaging, and lab tests. Lung function tests (also called pulmonary function tests): Spirometry: a type of lung test that measures the amount of air you can blow out in a single forced breath. Spirometry is used to diagnose lung diseases, including COPD and asthma. This test is required to confirm whether you have COPD. It should always be carried out, either by your GP or by a respiratory specialist after referral.In COPD, the inflammation and narrowing of the airways makes it harder to blow air out quickly. If your results are lower than expected, the test is repeated after you inhale a medication called a bronchodilator, which helps open the airways. In people with asthma, lung function can return to normal after this step, while in COPD it typically only improves partially. Spirometry is repeated regularly to monitor the progression of your COPD and to evaluate how well your treatment is working. Pulse oximetry: A small device that is put on the tip of the finger to measure oxygen levels in your blood. Lung volume test: this test measures how much air your lungs can hold at different points while breathing in and out. The test is usually done in a small booth (similar to a phone booth) where you breathe through a mouthpiece. In people with COPD, lung volume may be increased because not all the air can leave the lungs, due to airway narrowing or air trapping caused by lung damage. Lung diffusion test: this test measures how efficiently two gases, oxygen and carbon dioxide, move between the lungs and the bloodstream. In people with emphysema, this gas exchange is usually reduced. 6-minute walk test: This simple and inexpensive test is used to evaluate your exercise capacity. For this test, you will be asked to walk as far as possible along a flat corridor for 6 minutes. In this test, your pulse, difficulty breathing, and blood oxygen levels are usually measured in addition to the distance walked. The test is useful to track your disease progression, to evaluate the effects of a pulmonary rehabilitation programme, and to evaluate your response to treatment. Exercise stress test: This test measures how well your heart and lungs work during physical activity. While you exercise on a treadmill or stationary bike, your heart is monitored, and your lung function is evaluated to see how effectively they cope with the effort. Other tests used in the diagnosis of asthma: It is important to rule out asthma when assessing for COPD. This can be done through specific tests such as a bronchial challenge test or a FeNO (fractional exhaled nitric oxide) test. The results of spirometry can also help distinguish between COPD and asthma. You can find more information about how asthma is diagnosed here. Imaging: Chest X-ray: A chest X-ray can show lung changes caused by COPD. It can also help to rule out other lung diseases. A CT scan can show changes in the lungs caused by COPD, such as emphysema or thickening or widening of the larger airways due to inflammation. It can also help rule out other lung diseases. In some cases, the results can guide treatment decisions—for example, showing whether interventions like lung volume reduction with valves or surgery might be helpful. Many people with COPD also qualify for lung cancer screening with a low-dose CT scan. Lab tests: Arterial blood gas test measures how well your lungs deliver oxygen to your blood and how effectively they remove carbon dioxide. For this test, a small blood sample is taken from