Li R T, Rao Z Z, Fu Y H, Xu T L, Liu J M, Yu S C, Zhou M G, Dong W L, Hu Guoqing
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410078, China.
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2022 Feb 10;43(2):201-206. doi: 10.3760/cma.j.cn112338-20210803-00606.
To forecast the burden of chronic obstructive pulmonary disease (COPD) in China by 2030 and evaluate the effectiveness of controlling risk factors based on the predictive model. Based on the relationship between the death of COPD and exposure to risk factors and the theory of comparative risk assessment, we used the estimates of the Global Burden of Disease Study 2015 (GBD2015) for China, targets for controlling risk factors, and proportion change model to project the number of deaths, standardized mortality rate, and probability of premature mortality from chronic respiratory diseases by 2030 in different scenarios and to evaluate the impact of controlling the included risk factors to the disease burden of COPD in 2030. If the trends in exposure to risk factors from 1990 to 2015 continued, the number of deaths and the mortality for COPD would be 1.06 million and 73.85 per 100 000 population in China by 2030, respectively, with an increase of 15.81% and 10.69% compared to those in 2015. Compared to 2015, the age-standardized mortality rate would decrease by 38.88%, and the premature mortality would reduce by 52.73% by 2030. If the smoking rate and fine particulate matter (PM) concentration separately achieve their control targets by 2030, there would be 0.34 and 0.27 million deaths that could be avoided compared to the predicted numbers based on the natural trends in exposure to risk factors and the probability of premature death would reduce to 0.59% and 0.52%, respectively. If the control targets of all included risk factors were achieved by 2030, a total of 0.53 million deaths would be averted, and the probability of premature death would decrease to 0.44%. If the exposures to risk factors continued as showed from 1990 to 2015, the number of deaths and mortality for COPD would increase by 2030 compared to 2015, and the standardized mortality and the probability of premature death would decrease significantly, which would achieve the targets of preventing and controlling COPD. If the exposure to the included risk factors all achieved the targets by 2030, the burden of COPD would be reduced, suggesting that the control of tobacco use and air pollution should be enhanced to prevent and control COPD.
通过预测模型预测2030年中国慢性阻塞性肺疾病（COPD）的负担，并评估控制危险因素的效果。基于COPD死亡与危险因素暴露之间的关系以及比较风险评估理论，我们利用2015年全球疾病负担研究（GBD2015）对中国的估计数据、危险因素控制目标以及比例变化模型，预测不同情景下2030年慢性呼吸道疾病的死亡人数、标准化死亡率和过早死亡概率，并评估控制纳入的危险因素对2030年COPD疾病负担的影响。如果1990年至2015年危险因素暴露趋势持续，到2030年中国COPD的死亡人数和死亡率将分别达到106万和每10万人73.85例，与2015年相比分别增加15.81%和10.69%。与2015年相比，到2030年年龄标准化死亡率将下降38.88%，过早死亡概率将降低52.73%。如果吸烟率和细颗粒物（PM）浓度分别在2030年实现其控制目标，与基于危险因素暴露自然趋势预测的死亡人数相比，将分别避免34万和27万例死亡，过早死亡概率将分别降至0.59%和0.52%。如果到2030年所有纳入的危险因素控制目标均实现，总共可避免53万例死亡，过早死亡概率将降至0.44%。如果危险因素暴露如1990年至2015年所示持续，到2030年COPD的死亡人数和死亡率将比2015年增加，而标准化死亡率和过早死亡概率将显著下降，这将实现COPD的防控目标。如果到2030年所有纳入的危险因素暴露均实现目标，COPD的负担将减轻，这表明应加强烟草使用和空气污染的控制以预防和控制COPD。
