In Spain, many people live for years with a stubborn cough and constant phlegm, brushing these symptoms off as minor or routine. For some, though, they are early signs of bronchiectasis, a chronic lung disease that often goes unnoticed until the damage is permanent.
The Sociedad Española de Neumología y Cirugía Torácica (SEPAR) warns that too many people get used to ongoing respiratory problems, mistaking them for asthma, chronic bronchitis or the effects of smoking. This can delay diagnosis by more than six years on average, putting patients at risk of repeated infections and worsening lung function. SEPAR estimates that bronchiectasis affects about 3.6% of people in Spain, with underdiagnosis especially common in certain groups. The problem reflects wider concerns about chronic respiratory diseases in the country.
Recent data from the EMBARC registry show that previous exacerbations of bronchiectasis significantly increase the risk of future flare-ups. The findings highlight the importance of early detection and close monitoring.
EMBARC registry, 2026
Bronchiectasis develops when the bronchial tubes become permanently widened and damaged, making it harder for the lungs to clear mucus. In turn, infections and inflammation can take hold. Typical symptoms include a persistent cough, daily phlegm, frequent chest infections requiring antibiotics, breathlessness and tiredness. In severe cases, people may cough up blood or feel chest pain.
Standard chest X-rays often miss the disease in its early stages. Only a high-resolution CT scan can confirm the diagnosis, but basic care often skips this step. SEPAR and Spanish screening guidelines recommend low-dose CT scans to spot hidden lung problems, since regular X-rays may not catch the disease early.
Recent studies estimate there are 227 cases per 100,000 men and 309 per 100,000 women in Spain, with rates rising to about 1,100 per 100,000 among people over 80. The cause is unknown in up to 90% of cases, although past respiratory infections are a known trigger for some. SEPAR stresses that early diagnosis is critical because bronchiectasis is chronic and irreversible. When the disease is found late, repeated infections and loss of lung function are much harder to control.
In September 2026, SEPAR was a prominent voice in Spanish media on bronchiectasis, as well as COPD and asthma, drawing attention to widespread underdiagnosis of chronic lung diseases. For example, about 78% of COPD cases and between 20% and 70% of asthma cases in Spain remain undiagnosed, information from SEPAR.
SEPAR
SEPAR has launched the Año SEPAR de la Vía Aérea 2026-2027, a national campaign focused on asthma, COPD and bronchiectasis. It aims to raise awareness, encourage earlier doctor visits and improve coordination between primary care and lung specialists. These three diseases often overlap, complicating diagnosis and treatment. SEPAR calls for an integrated approach to improve patients' quality of life. The campaign aligns with Europe's broader focus on respiratory health, reflected at the 2026 ERS Congress in Barcelona, where the "Healthy Lungs for Life" campaign promoted lung function testing and public education.
Delays in diagnosis affect conditions beyond bronchiectasis. As reported earlier, problems in Spain's healthcare system have led to postponed care and missed opportunities for timely treatment of other serious conditions.
For anyone with ongoing respiratory symptoms, especially a chronic cough, daily phlegm or repeated infections, SEPAR's advice is clear: do not ignore these signs. Early medical evaluation is impressive to diagnose bronchiectasis and prevent complications from untreated disease. In Spain, where lung illnesses are often underestimated, the real danger lies in waiting too long. The evidence shows that acting early can make the difference between manageable symptoms and lasting lung damage.
Bronchiectasis remains underrecognized, but tools for early diagnosis and treatment are available. The challenge is ensuring that patients and doctors act before effective care becomes harder to provide.
