COPD Deaths Rival Heart Failure, Exceed Prostate and Breast Cancer

COPD carries a mortality burden that exceeds prostate and breast cancer and rivals heart failure, according to a real-world analysis of England's national health records led by Nicolas Roche, MD, of Hôpital Cochin in Paris, presented as a late-breaking abstract at the European Respiratory Society (ERS) Congress 2026 in Barcelona, Spain (September 5-9).¹

The findings echo a pattern already visible in US mortality data: COPD killed 141,733 people in the US in 2023, which makes it the fifth-leading cause of death nationally and places its annual toll well above that of prostate cancer (approximately 33,900 deaths) and breast cancer (approximately 42,000 to 43,000 deaths).^2,3 The combined 76,000 US deaths from prostate and breast cancer in 2023 are still well below COPD's annual death toll.

Roche and colleagues used England's linked national health records to directly compare mortality among patients with COPD against 3 conditions commonly perceived as carrying a heavier mortality burden: prostate cancer, breast cancer, and heart failure.¹ The researchers found that COPD not only outpaced the 2 cancers in mortality rate and risk but was comparable with heart failure overall and exceeded heart failure among patients with severe disease.

COPD Mortality Rates Outpaced Cancer, Matched Heart Failure

Using the Clinical Practice Research Datalink Aurum database linked to Hospital Episode Statistics and Office for National Statistics death registrations, the investigators identified adults in England diagnosed with COPD, prostate cancer, breast cancer, or heart failure between January 2014 and March 2020. Patients with COPD were matched 1:1 with comparators who had prostate cancer, breast cancer, or heart failure but not COPD, adjusting for age, sex, region, and deprivation index; a non-COPD general population cohort was also matched 2:1.

Across the overall COPD cohort, all-cause mortality rates were 60% and 67% higher than in patients with prostate or breast cancer, respectively, and mortality risk was 63% and 64% higher. Mortality among patients with COPD was statistically comparable with that of patients with heart failure. Among the subset with severe COPD, which was defined by more advanced airflow limitation, greater symptom burden, or a history of exacerbations, mortality rates and risk were more than double those of patients with prostate or breast cancer and 36% and 33% higher, respectively, than in patients with heart failure. The abstract text accompanying the poster cites slightly different figures for these same comparisons—55% to 74% higher versus prostate and breast cancer, and 31% to 37% higher versus heart failure in severe COPD.

The authors noted that despite this burden, COPD is frequently perceived by health systems and policy makers as a lesser threat than cancer or heart failure.

“Healthcare providers and systems should place greater emphasis on guideline‑directed COPD management to address this under‑recognised mortality burden,” they concluded in their abstract.

Why the Comparison Doesn't Translate Directly to the US, but the Underlying Pattern Does

The England-based cohort reflects a single-payer health system with its own patterns of smoking history, cancer screening uptake (which differs from US screening practices), and death-certificate coding conventions. However, based on the CDC figures, it’s clear the disease's outsized mortality burden relative to 2 of the country's most common cancers is not unique to England's health system.^2,3

A like-for-like US comparison between COPD and heart failure mortality using the same real-world methodology as the England study has not yet been published. The heart failure comparison is harder to anchor with US data. CDC reports that heart failure was mentioned on 452,573 US death certificates in 2023, accounting for 14.6% of all deaths, but does not specify if heart failure was an underlying cause of death or a contributing factor, which makes a direct comparison difficult.⁴

The research was funded by AstraZeneca, which develops COPD therapies.

References

1. Roche N, Cheng M, Hazra NC, et al. Late Breaking Abstract - Mortality in patients with COPD exceeds prostate and breast cancer and is comparable to heart failure: a real-world study from England. Presented at: ERS Congress 2026; September 5-9, 2026; Barcelona, Spain. Poster ID 474.
2. Chronic Obstructive Pulmonary Disease in Adults Age 18 and Older: United States, 2023. NCHS Data Brief No. 529. National Center for Health Statistics; 2025.
3. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2026. CA Cancer J Clin. 2026.
4. About Heart Failure. CDC. Accessed September 4, 2026.