Underdiagnosis and undertreatment of asthma: A 9-year study of Italian conscripts

Background: During the last 20 years, the epidemiology of asthma has been investigated in various populations, thus providing interesting data including the accuracy of diagnosis and the adequacy of treatment. Methods: We studied for 9 years the epidemiological features of asthma in a homogeneous population of 18-year-old males referred to La Spezia Military Navy Hospital for a call-up visit (conscripts). Results: During the period of 1990-1998, 91,700 men were screened at their call-up visit; out of them 5,371 (7%) had asthma, but in 7.4% the disease had not been previously diagnosed. During the observation period there was a significant decrease of the level III severity of asthma, but about one quarter of the asthmatic subjects received no treatment at all. On the other hand, a significant increase in the prescription of inhaled steroids was observed. Conclusion: Despite educational efforts, a not negligible underdiagnosis and inadequate treatment of asthma in young adults still persist.