COPD Prevalence in Europe Increases for Women

Across Europe, overall chronic obstructive pulmonary disease (COPD) prevalence from 2001 to 2019 has decreased for males. However, this decrease in prevalence was not found for females in most of the European countries analyzed in a recent study published in BMC Pulmonary Medicine.

In fact, COPD prevalence for females surpassed prevalence for males in some countries by 2019. Overall COPD mortality decreased across Europe from 2001 to 2019, with a larger decrease found among males than females.

Data for this study was collected from the Global Burden of Disease (GBD) database for the European Union (EU) member states and the United Kingdom (UK). Data was extracted for 28 countries from 2001 to 2019 and used to calculate COPD incidence, mortality, and disability-adjusted life-years (DALYs).

Researchers analyzed age-standardized prevalence rates (ASPRs), age-standardized mortality rates (ASMRs), and DALYs for each sex from 2001 to 2019 and reported these numbers per 100,000 population.

In 2019, the median ASPR across the 28 European countries was 3230/100,000 for males and 2202/100,000 for females. For males, the countries with the highest ASPRs were Belgium, Denmark, and Hungary while the countries with the lowest ASPRs were Latvia, Estonia, and France in 2019. For females in 2019, the highest ASPRs were found in Demark, the Netherlands, and the UK while the lowest ASPRs were found in Latvia, Lithuania, and Estonia.

The median change in ASPR from 2001 to 2019 was –372.9/100,000, or a percentage change of –9.7%, for males. For females, the median change in ASPR over the 19-year period was 97/100,000, or a percentage change of 4.3%. Decreased ASPRs were found in 23 of the 28 countries for males and 11 of the 28 countries for females.

In 2019, the median ASMR across the 28 European countries was 24/100,000 for males and 12/100,000 for females. The countries with the highest ASMRs in 2019 for males were Spain, Hungary, and Denmark while the countries with the lowest were France, Latvia, and Estonia. The highest ASMRs for females in 2019 were in Denmark, the UK, and Ireland and the lowest were found in Malta, Estonia, and Latvia.

The median change in ASMR from 2001 to 2019 was –9/100,000, or a percentage change of –27.5% for males. The median change in ASMR from 2001 to 2019 for females was –1/100,000, or a percentage change of –10.4%. A decrease in ASMR was found in 25 of the 28 countries for males and 19 of the 28 countries for females.

The median MIIs were 0.12 for males and 0.08 for females in 2019. The median percentage change in MIIs between 2001 and 2019 was –24.0% for males and –14.0% for females. A decrease in MII was found in 26 of the 28 countries for males and 25 and of the 28 countries for females.

The median DALYs in 2019 across Europe were 581/100,000 for males and 304/100,000 for females. From 2001 to 2019, the median change in DALYs for males was –179/100,000, or a percentage change of –25.7%. The median change in DALYs from 2001 to 2019 for females was –11/100,000, or a percentage change of –4.8%. A decrease in DALYs was found in 25 of the 28 countries for males and 18 of the 28 countries for females.

A limitation of this study is the observational data and possible variations in diagnostic practices medical records across the European countries. In addition, causality between the impact of healthcare policies and on COPD prevalence and mortality cannot be made. Also, there are many different variations of what defines a COPD diagnosis.

The burden of COPD across Europe remained high from 2001 to 2019 but there have been reductions in COPD-related mortality. “In contrast, while the prevalence of COPD continues to decrease in males across the majority of European nations, there are increasing trends in the prevalence of COPD in females,” the researchers concluded.

Reference

Marshall DC, Omari AL, Goodall R, et al. Trends in prevalence, mortality, and disability-adjusted life-years relating to chronic pulmonary disease in Europe: an observational study of the global burden of disease database, 2001-2019. BMC Pulm Med. 2022;22(1):289. doi: 10.1186/s12890-022-02074-z