A GOLD Science Committee Report on Universal Longitudinal Spirometry: A New Paradigm
Universal longitudinal spirometry for lifelong lung health
Over the last few decades, advances in prevention and treatment have transformed the landscape of several key chronic diseases.
By contrast, routine monitoring of lung function is absent despite compelling evidence that lung function predicts not only respiratory morbidity but also cardiometabolic conditions and overall mortality.
The paradigm shift we propose is to move spirometry from a diagnostic test performed after symptoms develop to a longitudinal measure of lung health used throughout the life course to identify abnormal trajectories early, guide preventive interventions, and preserve lifelong respiratory health.
Monitoring lung function from childhood
Accordingly, we argue that spirometry should be conducted universally from childhood, at periodic intervals throughout adolescence and into adulthood.
We recognize that the US Preventive Services Task Force (USPSTF) opposes populationbased spirometry screening, arguing it would not alter patient or physician behavior beyond recommending risk factor reduction, which should be enacted regardless of spirometry results.
Rather, spirometry should be viewed as a biomarker of lifelong health that enables the monitoring and interpretation of deviations from expected lung-function trajectories before irreversible disease develops.
Universal longitudinal spirometry: preserving lifelong lung health
Despite major successes in reducing mortality from other chronic diseases (e.g., cardiovascular), deaths from chronic lung disease continue to climb.
Establishing deviations from expected lung function trajectories early could enable the development of precision medicine approaches for lung disease.
The goal of spirometry should no longer be simply to diagnose disease, but to preserve lifelong lung health.
Authors
MeiLan K Han, Shawn D Aaron, Dinh Bui, Bartolome R Celli, Emily DeBoer, Shyamali Dharmage, David M G Halpin, Fernando J Martinez, Obianuju B Ozoh, Dave Singh, Claus Vogelmeier, Jadwiga Wedzicha, Alvar Agusti.
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Fecha de publicación
Published: 29 September 2026
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