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. 2016:2016:7518287.
doi: 10.1155/2016/7518287. Epub 2016 Jul 11.

Incidence, Prevalence, and Mortality Trends in Chronic Obstructive Pulmonary Disease over 2001 to 2011: A Public Health Point of View of the Burden

Mariève Doucet  1 , Louis Rochette  2 , Denis Hamel  2
Affiliations

Incidence, Prevalence, and Mortality Trends in Chronic Obstructive Pulmonary Disease over 2001 to 2011: A Public Health Point of View of the Burden

Mariève Doucet et al. Can Respir J. 2016.

Abstract

Background. An increase of chronic obstructive pulmonary disease (COPD) prevalence was reported in Canada despite the decline of the main risk factor. Objectives. To estimate incidence, prevalence, and mortality of COPD from 2001 to 2011 and establish the COPD burden by the evaluation of the age-period-cohort effects on incidence trends and the comorbidities prevalence estimations. Methods. A retrospective population-based cohort was built using Quebec health administrative data. Change in trends was measured by relative percentage of changes and by joinpoint regression. After a descriptive analysis of the trends, an age-period-cohort analysis was performed on incidence rates. Results. Overall increase in prevalence along with a decrease of incidence and all-cause mortality was observed. Over time, all age-standardized trends were higher in men than women. Despite higher rates, the number of incident and prevalent cases in women exceeds men since 2004. The curve analysis by age groups showed over time a downshift for both sexes in incidence and all-cause mortality. Further analysis showed the presence of a cohort effect in women. Conclusion. The burden of COPD has risen over time. Women younger than 65 years old have been identified as at-risk group for healthcare planning.

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Figures

Figure 1
Figure 1
COPD incidence. (a) Number of incidence diagnosed COPD cases, 35 years and older, by sex, Quebec, 2001–2011. (b) Age-standardized COPD incidence rates, 35 years and older, by sex, Quebec, 2001–2011. (c) Age-specific COPD incidence rates, by sex, Quebec, 2001 compared to 2011 period.
Figure 2
Figure 2
COPD prevalence. (a) Number of prevalent diagnosed COPD cases, 35 years and older, by sex, Quebec, 2001–2011. (b) Age-standardized COPD prevalence, 35 years and older, by sex, Quebec, 2001–2011. (c) Age-specific COPD prevalence, by sex, Quebec, 2001 compared to 2011 period.
Figure 3
Figure 3
COPD all-cause mortality. (a) Age-standardized all-cause mortality rates among individuals aged 35 years and older with diagnosed COPD to those without diagnosed COPD, by sex, Quebec, 2001–2011. (b) Age-specific COPD all-cause mortality rates, by sex, Quebec, 2001 compared to 2011 period.
Figure 4
Figure 4
Age-period-cohort effects in COPD incidence rates for males and females. (a) Age and period effects, by sex. (b) Cohort effect in men (median Polish method). (c) Cohort effect in females (median Polish method). (d) Cohort effect in men (Holford method). (e) Cohort effect in females (Holford method).
Figure 5
Figure 5
Comorbidities prevalence. (a) Age standardized comorbidities prevalence among COPD, 35 years and older, by sexes for the period 2011. (b) Rate ratios of age standardized comorbidities rate among individuals with and without COPD 35 years and older, by sexes for the period 2011.
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