COPD Morbidity & Mortality

COPD is the only leading cause of death in the world that is increasing in prevalence. According to the World Health Organization, in 1990, COPD was the sixth most common cause of death in the world. In the US, it ranks fourth as the most common cause of death. In Europe, the combined deaths associated with COPD, asthma, and pneumonia were the third most common cause of death. By 2020, it is estimated that COPD will rank fifth as the greatest burden to society.

Throughout the world, there is great variation on the number of deaths each year that are caused by COPD. Researchers suspect that these variations may be the result of:

• different behaviors in different countries (smoking habits, type and processing of tobacco used in cigarettes)
• environmental conditions (indoor and outdoor pollution, climate)
• frequency and management of respiratory infections
• genetic factors

The only consistency among the countries is that more men die of COPD than women each year. This fact, however, is beginning to show signs of change. Because chronic bronchitis results from chronic exposure of the airways to irritants, such as cigarette smoke or environmental pollution, and because more men than women have traditionally been smokers, the disease skews more heavily toward men. According to the National Center for Health Statistics, in the US, the percentage of women with chronic bronchitis is now increasing. In 1994, the last year for which data specific to chronic bronchitis is available, approximately 63 women out of 1,000 had chronic bronchitis, compared with 44.5 men out of 1,000.

When considering prevalence and incidence data, it is important to understand that prior to the mid-1990s, chronic bronchitis, emphysema, and often asthma were frequently considered as separate disease entities. In more recent years, data from these conditions (particularly chronic bronchitis and emphysema) are unified as COPDs.

United States

In the US, COPD is the fourth leading cause of death with a mortality of 18.6 per 100 000 population.  There has been a 70% increase in mortality over the last 20 years. This increase is remarkable, considering a decline in other diseases, such as cardiovascular disease, of 20% to 60% over the same time period.  In 1995, 4% of all deaths in the US were attributable to COPD.

Europe

In the UK, COPD is responsible for 5% of all deaths per year.  In 1996, over 24 000 deaths in England and Wales were attributed to COPD.

In summary Morbidity and Mortality of COPD;

• COPD ranks as the sixth most common cause of death worldwide, fourth in the US, and third in Europe, when combined with asthma and pneumonia
• by 2020, COPD is expected to rank as the fifth greatest burden to society
• more men than women die of COPD worldwide, but the gap is narrowing each year
• there has been a 70% increase in mortality due to COPD in the last 20 years in the US, while there has been a decline in other diseases
• in the UK, COPD is responsible for 5% of all deaths each year