Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis

Figures & data

Table 1 Summary estimates of prevalence for men and women for different definitions of COPD

Definition	No of studies (men/women)	Prevalence % (95% CrI)
		Men	Women
Overall	156/155	9.23 (8.16–10.36)	6.16 (5.41–6.95)
Age ≥40 years	97/97	11.55 (10.30–12.86)	7.47 (6.60–8.36)
Spirometry-based definition	75/75	13.09 (11.58–14.65)	7.59 (6.49–8.80)
Age ≥40 years and spirometry-based definition	51/51	14.71 (12.74–16.71)	8.70 (7.29–10.26)
Patient reported	52/52	4.92 (4.17–5.77)	4.89 (4.04–5.84)
Physician diagnosis	24/24	4.96 (2.93–7.52)	3.98 (2.18–6.20)
Mixed	23/23	10.64 (7.31–14.47)	6.13 (4.13–8.48)

Abbreviation: CrI, credible interval.

Table 2 Summary estimates of prevalence for men and women for various subregions, income groups, and study setting

Population	No of studies (men/women)	Prevalence % (95% CrI)
		Men	Women
Overall	156/155	9.23 (8.16–10.36)	6.16 (5.41–6.95)
Geographic regions
AMR A	39/38	8.07 (6.39–9.94)	7.30 (5.89–8.84)
AMR B	7/7	6.44 (4.34–8.98)	2.49 (1.22–4.20)
EUR A	64/64	9.13 (7.58–10.81)	6.10 (5.04–7.25)
EUR B	5/5	7.86 (3.15–11.63)	4.39 (1.56–8.51)
SEAR D	14/14	11.34 (8.32–14.68)	5.02 (3.81–6.42)
WPR A	7/7	10.14 (5.09–16.63)	6.16 (2.93–10.65)
WPR B	15/15	9.20 (5.89–13.20)	4.86 (2.79–7.48)
World Bank income groups
Lower-middle	10/10	7.49 (4.98–10.51)	2.98 (1.65–4.63)
Upper-middle	30/30	9.00 (7.14–11.01)	4.61 (3.37–5.98)
High	115/114	8.94 (7.81–10.15)	6.32 (5.52–7.22)
Study setting
Mixed/unclear	117/116	8.35 (7.12–9.58)	5.68 (4.85–6.58)
Rural	17/18	10.69 (6.89–15.24)	5.96 (3.81–8.54)
Urban	44/45	13.03 (11.28–14.92)	8.34 (7.06–9.75)

Note: Numbers in bold represent the highest prevalence in each stratification category for men and women.

Abbreviations: AMR A, Region of the Americas A; AMR B, Region of the Americas B; EUR A, European Region A; EUR B, European Region B; SEAR D, South-East Asian Region D; WPR A, Western Pacific Region A; WPR B, Western Pacific Region B; CrI, credible interval.

Table 3 Prevalence summary estimates for different age groups

Age subgroups	No of studies (men/women)	Prevalence % (95% CrI)
		Men	Women
15–39	22/22	3.57 (2.27–5.15)	3.35 (2.22–4.70)
40–69	51/51	10.08 (8.77–11.46)	6.30 (5.47–7.20)
70+	30/29	27.24 (22.43–32.52)	15.90 (12.97–19.18)
Broad	91/90	8.40 (7.22–9.70)	5.73 (4.90–6.62)

Note: Numbers in bold represent the highest prevalence for men and women.

Abbreviation: CrI, credible interval.

Table 4 Summary estimates of prevalence for men and women based on different diagnostic criteria

Spirometry-based diagnostic criteria	No of studies (men/women)	Prevalence % (95% CrI)
		Men	Women
FEV1/FVC <70%	59/59	13.47 (12.00–14.97)	7.75 (6.56–8.97)
FEV1/FVC <70% and FEV1 <80PP	12/12	9.74 (8.98–10.62)	5.96 (4.59–7.49)
FEV1/FVC <LLN	24/24	9.68 (7.52–12.22)	7.08 (5.29–9.13)

Note: Numbers in bold represent the highest prevalence category for men and women.

Abbreviations: CrI, credible interval; FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; LLN, lower limit of normal; PP, percent predicted.

Figure 1 Summary estimates of prevalence for men and women by severity.

Figure 2 Summary estimates of prevalence for men and women by calendar time.

Table 5 Summary of meta-regression analysis in men and women

Population	Coefficient	SD	MCSE	Median	95% CrI lower	95% CrI upper
Men
Age ≥40 years	0.085	0.033	0.001	0.085	0.022	0.155
Post-bronchodilator	0.265	0.042	0.003	0.265	0.186	0.350
Pre-bronchodilator	0.323	0.048	0.003	0.324	0.228	0.416
Unclear	0.229	0.046	0.002	0.229	0.135	0.318
Women
Age ≥40 years	0.047	0.031	0.002	0.049	−0.022	0.102
Post-bronchodilator	0.103	0.039	0.002	0.100	0.027	0.179
Pre-bronchodilator	0.191	0.047	0.003	0.189	0.103	0.286
Unclear	0.105	0.045	0.002	0.105	0.016	0.189

Abbreviations: CrI, credible interval; MCSE, Monte Carlo standard error.