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Prevalence of Chronic Obstructive Pulmonary Disease in China

A Large, Population-based Survey

¹ Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical College, Guangzhou, Guangdong, China; ² Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing, China; ³ The Third Hospital, Peking University, Beijing, China; ⁴ The Shenyang Military General Hospital, Shenyang, Liaoning, China; ⁵ The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, China; ⁶ Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China; ⁷ The General Hospital, Tianjin Medical University, Tianjin, China; ⁸ Xinqiao Hospital, The Third Military Medical University, Chongqing, China; ⁹ Xijing Hospital, The Fourth Military Medical University, Xi'an, Shanxi, China; ¹⁰ The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China; ¹¹ The First Municipal People Hospital of Shaoguan, Shaoguan, Guangdong, China; ¹² The Second Hospital of Liwan District of Guangzhou, Guangzhou, Guangdong, China; and ¹³ Department of Epidemiology, Guangzhou Medical College, Guangzhou, Guangdong, China

Correspondence and requests for reprints should be addressed to Pixin Ran, Ph.D., Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical College, 151 Yanjiang Road, Guangzhou, Guangdong, 510120, China. E-mail: pxran{at}gzhmc.edu.cn

Rationale: The prevalence of chronic obstructive pulmonary disease (COPD) in China is largely unknown.

Objectives: To obtain the COPD prevalence in China through a large-population, spirometry-based, cross-sectional survey of COPD.

Methods: Urban and rural population-based cluster samples were randomly selected from seven provinces/cities. All residents 40 years of age or older in the selected clusters were interviewed with a standardized questionnaire revised from the international BOLD (Burden of Obstructive Lung Diseases) study. Spirometry was performed on all eligible participants. Patients with airflow limitation (FEV₁/FVC < 0.70) were further examined by post-bronchodilator spirometry, chest radiograph, and electrocardiogram. Post-bronchodilator FEV₁/FVC of less than 70% was defined as the diagnostic criterion of COPD.

Measurements and Main Results: Among 25,627 sampling subjects, 20,245 participants completed the questionnaire and spirometry (response rate, 79.0%). The overall prevalence of COPD was 8.2% (men, 12.4%; women, 5.1%). The prevalence of COPD was significantly higher in rural residents, elderly patients, smokers, in those with lower body mass index, less education, and poor ventilation in the kitchen, in those who were exposed to occupational dusts or biomass fuels, and in those with pulmonary problems in childhood and family history of pulmonary diseases. Among the patients who had COPD, 35.3% were asymptomatic; only 35.1% reported lifetime diagnosis of bronchitis, emphysema, or other COPD; and only 6.5% have been tested with spirometry.

Conclusions: COPD is prevalent in individuals 40 years of age or older in China.

Key Words: chronic obstructive pulmonary disease • prevalence • epidemiology • cross-sectional studies • GOLD

AT A GLANCE COMMENTARY Scientific Knowledge on the Subject Chronic obstructive pulmonary disease is the fourth leading cause of morbidity and mortality in the United States, but its prevalence in China is largely unknown. What This Study Adds to the Field COPD is prevalent and underrecognized in individuals 40 years of age or older in China.

 

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