Gershon Andrea S, Wang Chengning, Wilton Andrew S, Raut Roxana, To Teresa
Institute for Clinical Evaluation Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Arch Intern Med. 2010 Mar 22;170(6):560-5. doi: 10.1001/archinternmed.2010.17.
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease with a prevalence of more than 10% worldwide among adults 40 years and older. Whether this amount has been increasing, decreasing, or stable over time remains unknown.
A longitudinal cohort study using population-based, health administrative data from 1991 to 2007 was conducted in Ontario, Canada. Individuals with COPD were identified using a previously validated health administrative case definition of COPD. Annual COPD prevalence, incidence, and all-cause mortality rates were estimated from 1996 to 2007.
The prevalence of COPD increased by 64.8% between 1996 and 2007. The age- and sex-standardized COPD prevalence rate increased from 7.8% to 9.5%, representing a relative increase of 23.0% (P < .001). The age- and sex-standardized incidence decreased from 11.8 per 1000 adults to 8.5 per 1000 adults, representing a relative decrease of 28.3% (P < .001). Finally, the age- and sex-standardized all-cause mortality rate decreased from 5.7% to 4.3%, representing a relative decrease of 24.0% (P < .001).
Our findings indicate a substantial increase in COPD prevalence in the last decade, with more of the burden being shifted from men to women. Effective clinical and public health strategies are needed to prevent COPD and manage the increasing number of people living longer with this disease.
慢性阻塞性肺疾病（COPD）是一种可预防和可治疗的疾病，在全球40岁及以上成年人中的患病率超过10%。随着时间的推移，这一患病率是上升、下降还是保持稳定尚不清楚。
在加拿大安大略省进行了一项纵向队列研究，使用1991年至2007年基于人群的卫生行政数据。通过先前验证的COPD卫生行政病例定义来识别COPD患者。估计了1996年至2007年的年度COPD患病率、发病率和全因死亡率。
1996年至2007年期间，COPD患病率增加了64.8%。年龄和性别标准化的COPD患病率从7.8%上升至9.5%，相对增加了23.0%（P <.001）。年龄和性别标准化发病率从每1000名成年人中的11.8例降至8.5例，相对下降了28.3%（P <.001）。最后，年龄和性别标准化的全因死亡率从5.7%降至4.3%，相对下降了24.0%（P <.001）。
我们的研究结果表明，在过去十年中COPD患病率大幅上升，且更多的负担从男性转移到了女性。需要有效的临床和公共卫生策略来预防COPD，并管理越来越多患有这种疾病且寿命更长的人群。
