Abstract
Background: In China, chronic obstructive pulmonary disease (COPD) was accounted for a quarter of the global COPD population and has become a large economic burden. However, the comprehensive picture of the COPD burden, is not readily available for all of the provinces of China. Methods: Using the GBD 2019, we analyzed the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) attributable to COPD across China and the corresponding time trends from 1990 to 2019, stratified by age and province. We also presented the contribution of risk factors to COPD-related mortality and DALYs. Findings: The absolute numbers of incidence and prevalence of COPD increased in 2019 as compared to in 1990, whereas the number of deaths and DALYs owing to COPD decreased from 1990 to 2019. The age-standardized rates (ASRs) of COPD burden continuously decreased from 1990 to 2019. The crude rates of COPD burden dramatically increased with age, and reached a peak at the age group of older than 95 years. In 2019, smoking was the most common risk factor for COPD mortality and DALYs in the whole population, but the most significant risk factor in females was ambient particulate matter pollution. At the provincial level, the ASRs of COPD burden were significantly associated with the SDIs, with the highest ASRs in the western provinces with low SDIs. Interpretation: China has a disproportionately high burden of COPD, suggesting that geographically targeted considerations should be developed to enhance COPD health and reduce the COPD burden throughout China and in specific provinces. Funding: This work is supported by the Guangdong Basic and Applied Basic Research Foundation (No. 2020B1515020004, No. 2021A1515011056), the National Natural Science Foundation of China (81873404); Project of Young Innovative Talents in Colleges and Universities in Guangdong Province (No. 2018KQNCX095), Affiliated Hospital of Guangdong Medical University Clinical Research Program (LCYJ2018C001, LCYJ2019B011). Declaration of Interest: We declare no competing interests.
Highlights
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality worldwide and results in a huge economic, social and health care burdens.[1,2,3,4] China is the largest developing country and has the largest number of active smokers (300 million adults).[5]
From 1990 to 2019, the incidence and prevalence of chronic obstructive pulmonary disease (COPD) increased by 61.2% and 67.8%, respectively, whereas the number of deaths and disability-adjusted life years (DALYs) owing to COPD decreased
The age-standardized rates (ASRs) of COPD burden was significantly associated with the socio-demographic index (SDI), with the highest ASRs in the western provinces with low SDIs
Summary
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality worldwide and results in a huge economic, social and health care burdens.[1,2,3,4] China is the largest developing country and has the largest number of active smokers (300 million adults).[5] The burden of COPD is expected to dramatically increase in coming decades due to the rapid aging Chinese population. COPD has become the main cause of mortality and disability, resulting in a very large economic burden.[6] The most recent Chinese national survey of COPD showed that China accounted for almost 25% of all COPD cases globally. In China, chronic obstructive pulmonary disease (COPD) was accounted for a quarter of the global COPD population and has become a large economic burden. We aimed to describe the burden of COPD in China, providing an up-to-date and comprehensive analysis at the national and provincial levels, and time trends from 1990 to 2019
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