Pulmonary Disease Unit, Department of Internal Medicine, Azienda Ospedali Riuniti, Ancona, Italy.
Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy.
Respirology. 2022 Nov;27(11):941-950. doi: 10.1111/resp.14328. Epub 2022 Jul 13.
Chronic obstructive pulmonary disease (COPD) incidence, prevalence, mortality and socioeconomic burden are considerable and vary across countries. The aim of the present study was to update the analysis of COPD mortality worldwide using data from the World Health Organization (WHO) up to 2019.
We obtained COPD mortality and population data for 22 European countries and the European Union (EU) as a whole, 10 American countries and six other countries from the WHO mortality database. We calculated age-standardized mortality rates in both sexes and examined trends by country with joinpoint analysis between 1994 and 2019.
Between 2005-2007 and 2015-2017, overall COPD mortality decreased in EU men (-16.3%) but increased in women (12.7%) to reach rates of 14.0/100,000 in men and of 6.4/100,000 in women. In the United States, mortality declined in men to 21.3/100,000 but rose in women to 18.3/100,000. Mortality declined in most Latin American countries and all Asian countries, while an increase in Australian women was observed.
A steady decrease in COPD mortality was observed in most of countries for men, whilst a different trend was observed in women in several countries. These trends are largely explained by changes in smoking habits, with an additional contribution of air pollution and occupational exposures. Despite past and ongoing tobacco control initiatives, this condition still remains a leading cause of death, in particular in countries with lower socio-demographic indices.
慢性阻塞性肺疾病(COPD)的发病率、患病率、死亡率和社会经济负担相当大,且在各国之间存在差异。本研究的目的是使用世界卫生组织(WHO)截至 2019 年的数据,更新全球 COPD 死亡率的分析。
我们从 WHO 死亡率数据库中获取了 22 个欧洲国家和整个欧盟、10 个美洲国家和其他 6 个国家的 COPD 死亡率和人口数据。我们计算了两性的年龄标准化死亡率,并通过连接点分析(1994 年至 2019 年)检查了各国的趋势。
在 2005-2007 年至 2015-2017 年期间,欧盟男性的总体 COPD 死亡率下降(-16.3%),而女性则上升(12.7%),男性达到 14.0/100,000,女性达到 6.4/100,000。在美国,男性的死亡率下降至 21.3/100,000,但女性的死亡率上升至 18.3/100,000。大多数拉丁美洲国家和所有亚洲国家的死亡率都有所下降,而澳大利亚女性的死亡率则有所上升。
在大多数国家,男性的 COPD 死亡率稳步下降,而在一些国家,女性的死亡率则呈现出不同的趋势。这些趋势在很大程度上归因于吸烟习惯的改变,空气污染和职业暴露也有一定的影响。尽管过去和正在进行的烟草控制举措,但这种情况仍然是主要的死亡原因,特别是在社会经济指数较低的国家。