Prevalence of Chronic Obstructive Pulmonary Disease in Cyprus: A Population-Based Study

Abstract

Background: The prevalence of Chronic Obstructive Pulmonary Disease (COPD) in Cyprus is largely unknown. The aim of the study was to estimate the prevalence of COPD in Cyprus through a spirometry population- based program and to identify certain disease characteristics in the Cypriot population. Methods: The study was performed in 1,233 randomly selected individuals covering representative urban and rural areas. Inclusion criteria were: age ≥ 35 years old and lifetime smoking history of at least 100 cigarettes. Participants answered a detailed questionnaire and underwent spirometry before and after the inhalation of 200 μg of salbutamol. COPD diagnosis and severity were based on criteria developed by the Global Initiative for Chronic Obstructive Lung Diseases. Results: The overall prevalence of spirometry diagnosed COPD subjects was 4.9% (5.1% in men vs 3.5% in women). Mild COPD was found in 33.3% of COPD individuals, moderate in 45%, severe and very severe COPD was found in 20% and 1.7%, respectively. Physician diagnosis was reported in 48.3% of spirometry diagnosed COPD subjects, whereas 55.9% were asymptomatic. Age (p = 0.000), increased tobacco consumption (p = 0.001) and cough with phlegm (p = 0.048) were found to have a synergistic effect on the diagnosis of COPD. Conclusions: Results suggest that COPD is an important health problem in Cyprus. Programs that raise public awareness focusing on prevention, early detection and treatment are needed. Under-diagnosis of COPD raises the need for spirometry screening programs in high risk individuals and guideline implementation for the management of the disease.

Keywords: :

• OPD
• Cyprus
• Prevalence
• Epidemiology
• Spirometry
• Smoking

Acknowledgments

Prof. K. Gourgoulianis and A. Georgiou coordinated the study. Principal investigators were A. G. Zachariades, T. Zachariadou and T. Adamide. Prof. K. Gourgoulianis, A. Georgiou and U. Anagnostopoulou contributed with ideas in the report and data analysis. The article was read and approved by all authors.

The authors would like to acknowledge the pulmonologists of the Respiratory Medicine Department of Nicosia General Hospital (M. Lemesios, M. Oikonomidou, A. Elevtheriou, the General Practitioners G. Athanasiou, Th. Kouppari), the assistant technician (Mrs. N. Agathokleous) and the secretary of the respiratory Medicine Department (Mrs. E. Andreou) for their contribution in the data collection of the study. We also thank Mr. S. Zannetos for the statistical analysis. This study was supported by the Ministry of Health of Cyprus.