Prevalence of Chronic Obstructive Pulmonary Disease in an Urban Area. Changes in COPD Ten Years on

Abstract

Purpose

The prevalence of Chronic obstructive pulmonary disease (COPD) in Spain has been evaluated in the last ten years by EPISCAN in 2007 and EPISCAN II in 2017. This study describes changes in the prevalence of COPD in an urban region of Spain in the last 10 years, its risk factors and underdiagnosis.

Patients and Methods

Participants from the Autonomous Community of Madrid (Spain) were selected from both studies up to the age of 80 years. A descriptive analysis of their sociodemographic and clinical characteristics, as well as by gender, was conducted. COPD was defined by a post-bronchodilator ratio <0.70.

Results

The prevalence of COPD in the Autonomous Community of Madrid increased non-significantly from 11.0% (95% CI: 8.9–13.5%) to 12.1% (95% CI: 9.6–15.1, p=0.612). However, the prevalence by gender showed an increase in women (5.6% to 14.7%, p<0.001) and a decrease in men (17.6% to 9.8%, p=0.08). Underdiagnosis was reduced from 81.0% to 67.9% (p=0.006), although with greater underdiagnosis in women (86.4% in EPISCAN and 100% in EPISCAN II). Smoking was higher in men than in women in EPISCAN (31.2% vs 23.0%, p<0.01) but with no differences by gender in EPISCAN II (25.5% men vs 26.0% women, p=0.146). Age, smoking, low BMI, and a sedentary lifestyle were consistently associated with COPD.

Conclusion

In 10 years in Madrid, there have been no changes in the global prevalence of COPD, but there have been important changes in women, with an increase in its prevalence, smoking habit and underdiagnosis.

Keywords:

• COPD
• prevalence
• Madrid
• spirometry

Ethics Approval

The study was approved by the Ethics Committee of the Hospital La Princesa (Madrid). Register number: 2899. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki.

Acknowledgments

We thank the staff and participants in EPI-SCAN and EPISCAN II studies and the scientific committee of both studies. We particularly thank Mónica Sarmiento and Neus Canal (IMS Health Economics and Outcomes Research, Barcelona, Spain) for the monitoring and data management of the studies. We also sincerely thank the scientific committee of IBERPOC: Sobradillo V, Jiménez CA, Gabriel R. Viejo JL, Masa JF, Fernández-Faue L, Villasante C.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

EGC has received speaker fees from GlaxoSmithKline, Chiesi and Pfizer. TAP has received speaker fees from AstraZeneca, GlaxoSmithKline, Chiesi, Novartis and Pfizer. JA has received company training fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline and Novartis and speaker fees from AstraZeneca, GlaxoSmithKline, Boehringer Ingelheim, Roche and Faes Farma. All other authors declare no conflicts of interest in this work.

Additional information

Funding

The EPI-SCAN study was funded by an unrestricted grant from GlaxoSmithKline Spain. EPISCAN II was a sponsored study from GlaxoSmithKline Spain registered in ClinicalTrials.gov Identifier: NCT01122758. All sponsors played no role in the study design, data collection, data analysis, data interpretation, or writing the original reports.