A summary of a commission article, published in The Lancet
A new paper, published in The Lancet journal, looks at progress in chronic obstructive pulmonary disease (COPD) prevention, diagnosis and treatment and what areas should be priorities for the future. The second Lancet Commission on COPD builds on the first, published in 2022 to give an update using the latest evidence in the field.
The Lancet Commission on COPD is a report led by a group of leading lung experts from around the world. The updated Commission, published in November 2026, examines new evidence on how COPD develops, reviews what has changed in the past four years and calls for a shift from trying to eliminate COPD towards protecting lung health throughout life.
While eliminating COPD remains a long-term goal, the focus should be on protecting lung health at all ages through stronger tobacco and nicotine control and policies that reduce harmful exposures
Protection should start before birth and continue through childhood and adulthood. This includes reducing air pollution, expanding vaccination (flu, COVID-19, RSV, pneumococcal) and addressing poverty.
Diagnosis should not only rely on spirometry as this could miss people who may benefit from early interventions. People with lung symptoms and known risk factors should be checked using additional tests, such as CT scans or other lung function measures, even if their initial breathing test results appear normal.
COPD should be defined by what causes it and the biological mechanisms involved, not just by symptoms. This enables healthcare professionals to develop personalised plans for preventing and treating the condition, tailored to each individual.
Exacerbations should be recognised as a serious event that can impact long-term lung health and not just a temporary worsening or flare-up. Each exacerbation should be checked using tests, such as inflammation markers or infection tests, rather than being defined by the treatment that is given. This approach could match treatments to the underlying cause and reduce the unnecessary use of steroids or antibiotics.
Research into COPD treatments needs to reflect that the disease has different causes and biological mechanisms in different people. Care should move away from a one-size-fits-all approach towards personalised treatment based on individual disease characteristics. Digital tools, such as remote monitoring and wearable devices, offer opportunities to improve diagnosis, track symptoms and prevent disease progression.
Treatment success should be judged by outcomes that matter to patients, including symptoms, independence, wellbeing, and quality of life rather than lung function alone. Research and regulations should look beyond breathing tests and include other measures, such as scans, digital monitoring and patient-reported outcomes.
This updated Commission provides a roadmap for change in COPD care over the next decade. Its recommendations could lead to:
On 11 November 2026 from 15:00-16:00 CET, the European Respiratory Society will host a webinar launching the updated Commission, bringing together patients, healthcare professionals, and researchers to discuss its findings. Patient advocate Pieter van Eck, who lives with COPD and is a member of the ELF COPD Patient Advisory Group, will share his perspective on the daily burden of the disease and the importance of working together to improve lung health from childhood and beyond.
Find out more about the event.
Read the original research paper: Reframing Progress in Chronic Obstructive Pulmonary Disease: From Elimination to Population Lung Health
