[2027: A new year for a new epidemiological study of chronic obstructive pulmonary disease in Spain].

A real opportunity exists to conduct a fourth epidemiological study of COPD in Spain by 2027, continuing the trilogy begun with IBERPOC (1997), EPISCAN (2007), and EPISCAN II (2017). These previous studies have been fundamental to understanding the evolution of COPD, showing a relative reduction in prevalence but a persistently high underdiagnosis rate (around 75%). The need for a new study is justified by six key reasons: 1) Monitoring the secular evolution of the disease. 2) Evaluating the impact of new exposures (pollution, vaping, etc.) and phenotypes (COPD in non-smokers, pre-COPD, etc.). 3) Integrating novel tests such as low-dose CT scans or biomarkers for earlier and more accurate diagnosis. 4) Validating new screening tools. 5) Evaluating the quality of care and the burden of disease in the post-COVID-19 era. 6) Creation of a prospective cohort for translational research. Novel funding models, such as final contributions, should be explored. This review argues that a study in 2027 would not be a mere repetition, but an opportunity to make a qualitative leap toward a multidimensional and precise characterization of COPD in Spain today.