Chest
Volume 116, Issue 2, August 1999, Pages 306-313
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Clinical Investigations
COPD
Trends in the Epidemiology of COPD in Canada, 1980 to 1995

https://doi.org/10.1378/chest.116.2.306Get rights and content

Purpose

To describe trends in the epidemiology of COPD in Canada from 1980 to 1995, in terms of perceived prevalence, mortality, and hospital morbidity.

Data sources

We limited the analysis to data related to chronic bronchitis, emphysema, or chronic airway obstruction not classified elsewhere, and excluded asthma (Ninth International Classification of Diseases, codes 490 to 492 and 496). The perceived prevalence rate of COPD was derived from the 1994–1995 National Health Survey. Mortality and hospital morbidity data (from 1980 to 1995) were obtained from the Health Statistics Division of Statistics Canada.

Results

From the National Health Survey, it was estimated that 750,000 Canadians had chronic bronchitis or emphysema diagnosed by a health professional. Prevalence rates were the following: ages 55 to 64 years, 4.6%; ages 65 to 74 years, 5.0%; ≥ 75 years, 6.8%. From 1980 to 1995, the total number of deaths from COPD increased from 4,438 to 8,583. Although the age-standardized mortality rate remained stable throughout this period in men (around 45/100,000 population), it doubled in women (8.3/100,000 in 1980 to 17.3/100,000 in 1995). There were 55,782 hospital separations in 1993–1994 with COPD as the primary discharge diagnosis (compared to 42,102 in 1981–1982). In people aged ≥ 65 years, the age-specific hospital separation rate increased over this period, especially in women ≥ 75 years (from 504/100,000 to 1,033/100,000). The average in-hospital length of stay was 9.6 days in 1981–1982 and 8.3 days in 1993–1994.

Conclusion

COPD represents a major health issue in Canada and will likely remain so for decades. Physician and non-physician health professionals who provide health care, as well as those who fund it must actively encourage approaches for primary and secondary prevention of this condition as well as approaches shown to be effective in addressing its associated impairment, disability, and handicap.

Section snippets

Data Sources

Data were obtained for the period from 1980 to 1995 with the cooperation of the Health Statistics Division of Statistics Canada. The data supplied included the prevalence, mortality, and hospital morbidity from COPD.

Prevalence: Estimates of the point prevalence of COPD were derived from the 1994–1995 National Population Health Survey conducted by Statistics Canada.11 The target population of this survey included household residents in all provinces, with the principal exclusion of the

Prevalence of COPD

The household survey estimated that almost three quarters of a million (749,714) Canadians had chronic bronchitis or emphysema diagnosed by a health professional. Prevalence rates according to gender and age-groups are presented in Table 2. In each of the three major age categories, the prevalence of COPD was higher among men than among women. For the population as a whole, the prevalence increased with age, the highest prevalence being recorded among men > 75 years old.

COPD-Related Mortality

In 1980, COPD accounted

Discussion

Changes in clinical practice and disease classification make it important to understand the real changes in prevalence, mortality, and morbidity from COPD. Comparison with similar information from other countries is hampered both by the updating of the ICD (now in its ninth version) and by the inclusion of asthma (ICD-9, code 493) in many reports of COPD.916 In order to obtain a clearer picture of the impact of COPD, we excluded from the analysis those with a diagnosis of asthma.

Conclusion

This survey suggests that COPD remains an important condition among Canadians and will likely continue to be for many years to come. Primary prevention among teenagers through strong media campaigns is most likely to influence the trends in the epidemiology of the disease. However, detailing the potential long-term health consequences of smoking (such as lung cancer and emphysema) is one of the least effective strategies that has been used in antismoking advertising campaigns, especially with

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