Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique

Figures & data

Table 1 Mean prevalence of COPD in 21 studies from 5 Northern Europe countries

Country	Source of samples	Setting	Age (years)	Diagnosis criteria	COPD prevalence (%)	Study
Denmark	Copenhagen	Urban	63	GOLD	17	Fabricius et al^Citation11
Denmark	Copenhagen	Urban	50	GOLD	25	Maio et al^Citation12
Denmark	Aarhus and Aalborg	Mixed	65	GOLD	12	Hansen et al^Citation13
Finland	Helsinki	Urban	49	GOLD/LLN	6	Kainu et al^Citation14
Finland	Lahti	Rural	48	GOLD	9	Jyrki-Tapani et al^Citation15
Finland	Lieto	Rural	73	FEV1/FVC ≤65%	8	Isoaho et al^Citation16
Finland	Ylöjärvi	Mixed	55	GOLD	5	Kanervisto et al^Citation17
Iceland	Reykjavik	Urban	57	GOLD	18	Benediktsdóttir et al^Citation18
Norway	Hordaland county	Mixed	55	GOLD	9	Waatevik et al^Citation19
Norway	Bergen municipality	Mixed	61	GOLD	9	Hvidsten et al^Citation20
Norway	Bergen	Urban	58	GOLD	19	Buist et al^Citation21
Norway	Hordaland county	Mixed	42	GOLD	5	Bakke et al^Citation22
Norway	Bergen municipality	Mixed	46	GOLD	5	Johannessen et al^Citation23
Sweden	Uppsala	Urban	59	LLN	10	Danielsson et al^Citation24
Sweden	Lulea	Rural	61	GOLD	14	Lindberg et al^Citation25
Sweden	Lulea	Rural	49	GOLD	14	Lindberg et al^Citation26
Sweden	Norrbotten county	Rural	61	GOLD	11	Lindberg et al^Citation26
Sweden	Northern Sweden	Rural	50	BTS	10	Lindström et al^Citation27
Sweden	Stockholm	Urban	53	GOLD	20	Maio et al^Citation12
Sweden	Värmland county	Rural	45	BTS	2	Hasselgren et al^Citation28
Sweden	Örebro	Mixed	49	ATS	11	Larsson^Citation29

Note: The numerical values of age and prevalence have been rounded.

Abbreviations: ATS, American Thoracic Society; BTS, British Thoracic Society; GOLD, Global Initiative for Chronic Obstructive Lung Disease; LLN, lower limit of normal.

Table 2 Mean prevalence of COPD in 11 studies from 3 Western Europe countries

Country	Source of samples	Setting	Age (years)	Diagnosis criteria	COPD prevalence (%)	Study
France	Paris	Urban	63	GOLD	7	Roche et al^Citation30
the Netherlands	Maastricht	Urban	59	GOLD/LLN	19	Vanfleteren et al^Citation31
the Netherlands	Rotterdam	Urban	69	GOLD	12	van Durme et al^Citation32
the Netherlands	General population of the whole country	Mixed	58	GOLD	4	Afonso et al^Citation33
UK	Birmingham	Mixed	58	GOLD	9	Jordan et al^Citation34
UK	Ashington	Urban	59	GOLD	25	Melville et al^Citation35
UK	Greater Belfast area	Mixed	55	ATS	7	Murtagh et al^Citation36
UK	Glasgow	Urban	51	GOLD	24	Maio et al^Citation12
UK	Barton-upon-Humber	Mixed	68	GOLD	10	Dickinson et al^Citation37
UK	Manchester	Mixed	64	GOLD	26	Renwick and Connolly^Citation38
UK	General population of the whole country	Mixed	56	GOLD	13	Shahab et al^Citation39

Note: The numerical values of age and prevalence have been rounded.

Abbreviations: ATS, American Thoracic Society; GOLD, Global Initiative for Chronic Obstructive Lung Disease; LLN, lower limit of normal.

Table 3 Mean prevalence of COPD in 14 studies from 5 Central Europe countries

Country	Source of samples	Setting	Age (years)	Diagnosis criteria	COPD prevalence (%)	Study
Austria	Salzburg	Mixed	58	GOLD	17	Weiss et al^Citation40
Austria	Salzburg	Urban	59	GOLD	26	Schirnhofer et al^Citation41
Austria	Vienna	Urban	56	GOLD	20	Maio et al^Citation12
Germany	Hannover	Mixed	58	GOLD	13	Geldmacher et al^Citation42
Germany	Dusseldorf	Urban	59	GOLD	9	Gingter et al^Citation43
Germany	Munich	Urban	59	GOLD	21	Maio et al^Citation12
Germany	Berlin	Urban	41	GOLD	16	Maio et al^Citation12
Poland	Warsaw	Mixed	57	LLN	9	Bednarek et al^Citation44
Poland	Malopolska province	Mixed	56	GOLD	22	Nizankowska-Mogilnicka et al^Citation45
Poland	Warsaw	Urban	49	GOLD	11	Plywaczewski et al^Citation46
Poland	Lublin region	Rural	50	GOLD	11	Paprzycki et al^Citation47
Poland	Bytom	Mixed	59	GOLD	6	Siatkowska et al^Citation48
Slovenia	Sezana (Carso)	Urban	56	GOLD	10	Grzetic-Romcevic et al^Citation49
Switzerland	General population of the whole country	Mixed	54	GOLD	5	Bridevaux et al^Citation50

Note: The numerical values of age and prevalence have been rounded.

Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; LLN, lower limit of normal.

Table 4 Mean prevalence of COPD in 15 studies from 6 Southern Europe countries

Country	Source of samples	Setting	Age (years)	Diagnosis criteria	COPD prevalence (%)	Study
Portugal	Lisbon	Urban	63	GOLD	14	Bárbara et al^Citation51
Portugal	General population of the whole country	Mixed	56	GOLD	9	Cardoso et al^Citation52
Portugal	Porto	Urban	58	GOLD	11	Mascarenhas et al^Citation53
Spain	Multicenter study on 11 cities	Mixed	57	GOLD	10	Miravitlles et al^Citation54
Spain	Multicenter study on 7 geographical areas	Mixed	54	ERS	9	Peña et al^Citation55
Spain	Canary Islands	Urban	55	GOLD	7	Cabrera López et al^Citation56
Italy	Po Delta area	Rural	57	GOLD	23	Viegi et al^Citation57
Italy	Verona	Mixed	56	GOLD/LLN	12	Guerriero et al^Citation64
Greece	Exochi, Thessaloniki	Mixed	52	GOLD	6	Sichletidis et al^Citation58
Greece	Thessaly region	Rural	54	GOLD	18	Minas et al^Citation59
Cyprus	General population of the whole island	Mixed	54	GOLD	5	Zachariades et al^Citation60
Turkey	Kocaeli city	Urban	56	GOLD	13	Arslan et al^Citation61
Turkey	Erzurum	Rural	55	GOLD	5	Erdogan et al^Citation62
Turkey	Malatya region	Mixed	47	ATS/ERS	7	Gunen et al^Citation63
Turkey	Adana	Mixed	54	GOLD	19	Buist et al^Citation21

Note: The numerical values of age and prevalence have been rounded.

Abbreviations: ATS, American Thoracic Society; ERS, European Respiratory Society; GOLD, Global Initiative for Chronic Obstructive Lung Disease; LLN, lower limit of normal.

Table 5 Ages of selected samples, descriptive statistics

Region	Number of studies	Mean (years)	SD	95% CI (lower limit)	95% CI (upper limit)	Minimum	Maximum
Northern Europe	21	54.8	7.7	51.3	58.3	42.0	73.0
Western Europe	11	60.3	5.6	56.5	64.0	50.9	69.5
Central Europe	14	55.0	5.2	52.0	58.1	40.1	59.5
Southern Europe	16	55.2	3.2	53.5	56.9	47.5	62.8
Global	62	55.9	6.1	54.4	57.5	40.8	73.0

Note: Interregions: p=0.071, no significant differences (ANOVA).

Abbreviation: ANOVA, analysis of variance.

Table 6 COPD prevalence in Europe, descriptive statistics

Region	Number of studies	Mean prevalence (%)	SD	95% CI (lower limit)	95% CI (upper limit)	Minimum	Maximum
Northern Europe	21	11.5	5.9	8.8	14.1	2.1	25.4
Western Europe	11	14.2	8.0	8.8	19.6	3.9	26.4
Central Europe	14	14.1	6.5	10.4	17.9	5.0	26.1
Southern Europe	16	10.8	5.6	7.8	13.8	4.9	23.4
Global	62	12.4	6.2	10.8	14.0	2.1	26.4

Note: Interregions: p=0.3460, no significant differences (ANOVA).

Abbreviation: ANOVA, analysis of variance.

Figure 1 COPD mean prevalence in Europe.

Notes: In this IDW interpolation map, the COPD prevalence is represented by a red–blue scale. Black spots indicate the places of origin of the data obtained from 62 selected studies. Some black spots are also shown in some nearby countries of North Africa and Middle East for guidance.
Abbreviation: IDW, inverse distance weighting.

Figure 2 COPD mean prevalence in Europe.

Note: The IDW interpolation map shows the prevalence values of COPD at the points of origin of the patients, both in Europe and in some neighboring countries in North Africa and the Middle East.
Abbreviation: IDW, inverse distance weighting.

Figure 3 COPD mean prevalence in Europe.

Notes: In this IDW interpolation map, spots and numerical values have been removed to allow a clearer view of the colors with which the different regions appear colored. Although there is not an exact equivalence between the qualitative data provided by the color scale and the numerical values obtained from published studies, there is an approximate correlation between them, which allows interpreting findings of the mapping with reasonable certainty.
Abbreviation: IDW, inverse distance weighting.

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