One out of every four people aged 35 and older are likely to develop chronic obstructive pulmonary disease (COPD)* during their lifetime, according to the first comprehensive estimate of lifetime risk for COPD published in a special European Respiratory Society issue of The Lancet. The findings suggest that people are at much greater risk of developing COPD than congestive heart failure, acute heart attack, and several common cancers.
According to the results, the average 35-year-old women is more than three times as likely to get COPD than breast cancer during her lifetime, and the average 35-year-old man is at more than three times greater risk of developing COPD than prostate cancer.
COPD is projected to be the third most common cause of death worldwide by 2030, is a leading cause of hospitalisation, and one of the most costly chronic diseases. Yet, there is little public awareness of COPD and the disease does not receive the same funding, research, and profile as diseases with a similar burden, such as diabetes.
Andrea Gershon from the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada and colleagues aimed to quantify the lifetime risk of developing physician-diagnosed COPD using population-based health administrative data for the entire population of Ontario (about 13 million people). All individuals between 35 and 80 years of age without COPD in 1996 were followed for up to 14 years. A total of 579 466 cases of COPD were diagnosed during the study.
Overall, the estimated lifetime risk of developing physician-diagnosed COPD was 27.6% (or a one in four chance). The risk was higher in men (29.7% or almost one in three) than in women (25.6% one in four). Lower socioeconomic status and living in a rural area also increased the lifetime risk of getting COPD.
The authors point out: "COPD had a lifetime risk comparable to diabetes and asthma. Its lifetime risk was about double that of congestive heart failure…three to four times that of acute myocardial infarction, breast cancer [in women], and prostate cancer [in men]…and more than seven times that of other cancers."**
They conclude: "Our novel findings draw attention to the huge burden of COPD on society and can be used to educate the public about the need for attention and resources to combat the disease…[and to] justify the continuation of smoking cessation programmes, and the development of other strategies to optimise COPD care to improve the lives of affected individuals, their families, and their communities."
In a Comment, David Mannino from the University of Kentucky College of Public Health, Lexington, USA and Fernando Martinez from the University of Michigan Health System, Michigan, USA say that these findings are particularly important because: "Until recently, there has been little public awareness about COPD and the disease has received few resources from funding agencies. The amount spent on research per case still lags behind that of other chronic and malignant diseases."
Dr Andrea Gershon, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. Via Deborah Creatura, Media Advisor, Institute for Clinical Evaluative Sciences T) +1 416 480 4780 or +1 647 406 5996 E) deborah.creatura@ices.on.ca
Dr Fernando Martinez, University of Michigan Health System, Michigan, USA. T) +1 134 763 2540 E) fmartine@umich.edu
Notes to Editors: *COPD is characterised by a chronic, progressive and largely irreversible obstruction of the airways, restricting a patient's respiratory function and hence reducing their physical activity and increasing their vulnerability to other conditions such as chest infections.
**Quote direct from authors and cannot be found in text of Article.
Journal
The Lancet