Published ahead of print on June 15, 2007, doi:10.1164/rccm.200612-1749OC Am. J. Respir. Crit. Care Med., Volume 176, Number 8, October 2007, 753-760 A more recent version of this article appeared on October 15, 2007
Submitted on December 2, 2006 Prevalence of Chronic Obstructive Pulmonary Disease in China: A Large Population-based SurveyNanshan Zhong1,1 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 Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical College, Guangzhou, Guangdong, China; 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, 13 Department of Epidemiology, Guangzhou Medical College, Guangzhou, Guangdong, China * To whom correspondence should be addressed. 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 aged 40 years 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. Those with airflow limitation (forced expiratory volume in one second over forced vital capacity [FEV1/FVC] <0.70) were further examined by post bronchodilator spirometry, chest X-ray and electrocardiogram. Post-bronchodilator FEV1/FVC of less than 70% was defined as the diagnostic criterion of COPD. Results: Among 25627 sampling subjects, 20245 participants completed both 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, in elders, in smokers, in those with lower body mass index, less education, 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 COPD patients, 35.3% of them were asymptomatic; only 35.1% reported lifetime diagnosis of bronchitis, emphysema, or other chronic obstructive pulmonary diseases; and only 6.5% have been tested with spirometry. Conclusions: COPD is prevalent in individuals aged 40 years or older in China. Key words: COPD; prevalence; epidemiology; cross-sectional studies; GOLD
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