Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam Study.

Natalie Terzikhan,Katia M C Verhamme,Guy G Brusselle,Albert Hofman,Lies Lahousse,Bruno H Stricker

doi:10.1007/s10654-016-0132-z

Natalie Terzikhan, Katia M C Verhamme + Show 4 more

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https://doi.org/10.1007/s10654-016-0132-z

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Abstract

COPD is the third leading cause of death in the world and its global burden is predicted to increase further. Even though the prevalence of COPD is well studied, only few studies examined the incidence of COPD in a prospective and standardized manner. In a prospective population-based cohort study (Rotterdam Study) enrolling subjects aged ≥45, COPD was diagnosed based on a pre-bronchodilator obstructive spirometry (FEV1/FVC < 0.70). In absence of an interpretable spirometry within the Rotterdam Study, cases were defined as having COPD diagnosed by a physician on the basis of clinical presentation and obstructive lung function measured by the general practitioner or respiratory physician. Incidence rates were calculated by dividing the number of incident cases by the total number of person years of subjects at risk. In this cohort of 14,619 participants, 1993 subjects with COPD were identified of whom 689 as prevalent ones and 1304 cases as incident ones. The overall incidence rate (IR) of COPD was 8.9/1000 person-years (PY); 95 % Confidence Interval (CI) 8.4–9.4. The IR was higher in males and in smokers. The proportion of female COPD participants without a history of smoking was 27.2 %, while this proportion was 7.3 % in males. The prevalence of COPD in the Rotterdam Study is 4.7 % and the overall incidence is approximately 9/1000 PY, with a higher incidence in males and in smokers. The proportion of never-smokers among female COPD cases is substantial.Electronic supplementary materialThe online version of this article (doi:10.1007/s10654-016-0132-z) contains supplementary material, which is available to authorized users.

Highlights

Worldwide, Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death [1]
In absence of an interpretable spirometry within the Rotterdam Study, cases were defined as having COPD diagnosed by a physician on the basis of clinical presentation and obstructive lung function measured by the general practitioner or respiratory physician
Physician diagnosed asthma patients (n = 460) were excluded from the COPD cases, but were controls, as they were at risk to develop COPD

Summary

Introduction

Chronic Obstructive Pulmonary Disease (COPD) is the third leading cause of death [1]. COPD is characterized by persistent airflow limitation that is typically progressive and associated with an enhanced chronic inflammatory response in the airways and lung tissue to harmful particles or gases [2]. The chronic airflow limitation in COPD is caused by the combination of parenchymal destruction (emphysema) and small airways disease (obstructive bronchiolitis), of which the relative presence varies from person to person [2]. According to estimates from the Global Burden of Disease Study, COPD was prevalent in more than 300 million people in 2013 [3]. In European adult populations over 40 years, the prevalence of COPD ranges between 15–20 % and is higher in men than in women [7,8,9]. Even though the prevalence of COPD is well known, only few studies examined its incidence rate in a prospective and standardized manner (supplementary Table 1S in the Online Resource provides an overview of studies which investigated the incidence of COPD)

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