Why Screen All COPD Patients for AAT Deficiency?

Alpha-1 Screening Guidelines

Five major clinical organizations recommend an alpha-1 screening test for all COPD patients: the COPD Foundation, American Thoracic Society (ATS), Global Initiative for Chronic Obstructive Lung Disease (GOLD), World Health Organization (WHO), and American College of Chest Physicians (CHEST)1-5:

The ATS recommends screening all COPD patients regardless of age, smoking history, ethnicity, or FEV1 status, and in addition1:

  • All adults with symptomatic COPD, regardless of smoking history
  • All adults with symptomatic emphysema, regardless of smoking history
  • All adults with symptomatic asthma whose airflow obstruction is incompletely reversible after bronchodilator therapy
  • Asymptomatic patients with persistent obstruction on pulmonary function tests and with identifiable risk factors (eg, smoking, occupational exposure)
  • All immediate family members of individuals with AAT deficiency

Up Next: Diagnostic Journey

FEV1, forced expiratory volume in 1 second.


  1. American Thoracic Society/European Respiratory Society. American Thoracic Society/European Respiratory Society statement: standards for the diagnosis and management of individuals with alpha-1 antitrypsin deficiency. Am J Respir Crit Care Med. 2003;168(7):818-900.
  2. Sandhaus RA, Turino G, Brantly ML, et al. The diagnosis and management of alpha-1 antitrypsin deficiency in the adult. Chronic Obstr Pulm Dis. 2016;3(3):668-682.
  3. Global Initiative for Chronic Obstructive Lung Disease. Pocket guide to COPD diagnosis, management, and prevention. 2019 report. https://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-POCKET-GUIDE-DRAFT-v1.7-14Nov2018-WMS.pdf. Accessed November 7, 2019.
  4. World Health Organization. α1-antitrypsin deficiency: memorandum from a WHO meeting. Bull World Health Organ.1997;75(5):397-415.
  5. CHEST Foundation. Learn about alpha-1 antitrypsin deficiency. https://foundation.chestnet.org/patient-education-resources/alpha-1-antitrypsin-deficiency/. Accessed July 12, 2021.