Servicio de Neumología, Hospital de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain.
Arch Bronconeumol. 2013 Jun;49(6):223-9. doi: 10.1016/j.arbres.2012.11.010. Epub 2013 Jan 12.
The distribution of chronic obstructive pulmonary disease (COPD) in women, and its underdiagnosis and determinants in the general population, have not been well described. The EPI-SCAN study is an epidemiologic, observational study conducted at 11 Spanish centers on the general population aged 40 to 80.
This paper describes the rates and extrapolates the population burden from the 3,802 participants of the EPI-SCAN study.
With 2,005 female and 1,797 male participants, there was a lower prevalence of COPD in women (5.7%; 95%CI, 4.7-6.7) than in men (15.1%; 95%CI, 13.5-16.8; P<.05). Among the 386 participants with COPD, 114 (29.5%) were women, who were younger, currently smoked less and had lower tobacco smoke exposure, while reporting a lower level of education (P<.05). As for the respiratory symptoms, there were no differences between sexes for cough, dyspnea or wheezing, but the women with COPD reported sputum less frequently (P<.05). There were no differences in the spirometric severity of COPD between women and men. Overall, 73% of the patients with a spirometric COPD criteria were underdiagnosed, and this percentage is unevenly distributed by sex, being 1.27 times more frequent in women (86.0%) than in men (67.6%) (P<.05). By extrapolating the rates of prevalence and underdiagnosis of COPD to the general population, we estimate that there are 628,102 Spanish women between the ages of 40 and 80 with COPD, 540,168 of whom still have not been diagnosed.
There is a greater underdiagnosis of COPD in women than in men in Spain.
慢性阻塞性肺疾病（COPD）在女性中的分布情况以及其在普通人群中的漏诊率和决定因素尚未得到充分描述。EPI-SCAN 研究是一项在西班牙 11 个中心进行的、针对 40 至 80 岁普通人群的流行病学、观察性研究。
本文描述了 EPI-SCAN 研究中 3802 名参与者的发病率，并对其进行了人群负担的推断。
在 2005 名女性和 1797 名男性参与者中，女性 COPD 的患病率较低（5.7%；95%CI，4.7-6.7），而男性 COPD 的患病率较高（15.1%；95%CI，13.5-16.8；P<.05）。在 386 名 COPD 患者中，有 114 名（29.5%）为女性，她们年龄较小、当前吸烟较少、烟草暴露水平较低，同时受教育程度较低（P<.05）。在呼吸系统症状方面，男女之间咳嗽、呼吸困难或喘息无差异，但 COPD 女性报告咳痰较少（P<.05）。女性和男性 COPD 的肺功能严重程度无差异。总体而言，有 73%的符合肺功能诊断标准的 COPD 患者被漏诊，且这种漏诊情况在性别之间分布不均，女性（86.0%）比男性（67.6%）高 1.27 倍（P<.05）。通过对 COPD 的患病率和漏诊率进行人群推断，我们估计在西班牙有 628102 名年龄在 40 至 80 岁之间的女性患有 COPD，其中 540168 名尚未被诊断。
在西班牙，女性 COPD 的漏诊率高于男性。
