Whittaker Hannah, Kramer Fiala Machado Adriana, Hatam Sara, Cook Sarah, Scully Sean, Evans Hywel Turner T, Bolton Thomas, Kallis Constantinos, Busby John, Heaney Liam G, Sheikh Aziz, Quint Jennifer K
School of Public Health, Imperial College London, London, UK
Queen's University Belfast, Belfast, UK.
Thorax. 2025 Jun 16;80(7):466-477. doi: 10.1136/thorax-2024-222699.
We describe the epidemiology of asthma, chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) from 2004 to 2023 in England, Wales, Scotland and Northern Ireland (NI) using a harmonised approach.
Data from the National Health Service England (NHSE), Clinical Practice Research Datalink Aurum in England, Secure Anonymised Information Linkage Databank in Wales, DataLoch in South-East Scotland and the Honest Broker Service in NI were used. A harmonised approach to COPD, asthma and ILD case definitions, study designs and study populations across the four nations was performed. Age-sex-standardised incidence rates and point prevalence were calculated between 2004 and 2023 depending on data availability. Logistic and negative binomial regression compared incidence and prevalence rates between the start and end of each study period. Linear extrapolation projected incidence rates between 2020 and 2023 to illustrate how observed and projected rates differed.
Incidence rates were lower in 2019 versus 2005 for asthma (England: incidence rate ratio 0.89, 95% CI 0.88 to 0.90; Wales: 0.66, 0.65 to 0.68; Scotland: 0.67, 0.64 to 0.71; NI: 0.84, 0.81 to 0.86), COPD (England: 0.83, 0.82 to 0.85; Wales: 0.67, 0.65 to 0.69) and higher for ILD (England: 3.27, 3.05 to 3.50; Wales: 1.39, 1.27 to 1.53; Scotland: 1.63, 1.36 to 1.95; NI: 3.03, 2.47 to 3.72). In NHSE, the incidence of asthma was similar in June 2023 versus November 2019, but lower for COPD and higher for ILD. Prevalence of asthma in 2019 in England, Wales, Scotland and NI was 9.7%, 15.9%, 13.2% and 7.0%, respectively, for COPD 4.5%, 5.1%, 4.4% and 3.0%, and for ILD 0.4%, 0.5%, 0.6% and 0.3%. Projected incidence rates were 2.8, 3.4 and 1.8 times lower for asthma, COPD and ILD compared with observed rates at the height of the pandemic.
Asthma, COPD and ILD affect over 10 million people across the four nations, and a substantial number of diagnoses were missed during the pandemic.
我们采用统一方法描述了2004年至2023年英格兰、威尔士、苏格兰和北爱尔兰哮喘、慢性阻塞性肺疾病（COPD）和间质性肺疾病（ILD）的流行病学情况。
使用了来自英格兰国民医疗服务体系（NHSE）、英格兰临床实践研究数据链奥鲁姆、威尔士安全匿名信息链接数据库、苏格兰东南部数据湖以及北爱尔兰诚信中介服务的数据。对四个国家的COPD、哮喘和ILD病例定义、研究设计和研究人群采用了统一方法。根据数据可用性计算了2004年至2023年期间的年龄 - 性别标准化发病率和时点患病率。逻辑回归和负二项回归比较了每个研究期开始和结束时的发病率和患病率。线性外推法预测了2020年至2023年的发病率，以说明观察到的发病率和预测发病率的差异。
与2005年相比，2019年哮喘的发病率较低（英格兰：发病率比0.89，95%置信区间0.88至0.90；威尔士：0.66，0.65至0.68；苏格兰：0.67，0.64至0.71；北爱尔兰：0.84，0.81至0.86），COPD（英格兰：0.83，0.82至0.85；威尔士：0.67，0.65至0.69），而ILD的发病率较高（英格兰：3.27，3.05至3.50；威尔士：1.39，1.27至1.53；苏格兰：1.63，1.36至1.95；北爱尔兰：3.03，2.47至3.72）。在NHSE中，2023年6月哮喘的发病率与2019年11月相似，但COPD的发病率较低，ILD的发病率较高。2019年英格兰、威尔士、苏格兰和北爱尔兰哮喘的患病率分别为9.7%、15.9%、13.2%和7.0%，COPD分别为4.5%、5.1%、4.4%和3.0%，ILD分别为0.4%、0.5%、0.6%和0.3%。与疫情高峰期观察到的发病率相比，哮喘、COPD和ILD的预测发病率分别低2.8倍、3.4倍和1.8倍。
哮喘、COPD和ILD影响了四个国家超过1000万人，并且在疫情期间有大量诊断被漏诊。
