A Subnational Analysis of Mortality and Prevalence of COPD in China From 1990 to 2013: Findings From the Global Burden of Disease Study 2013

doi:10.1016/j.chest.2016.08.1474

Chest

Volume 150, Issue 6, December 2016, Pages 1269-1280

https://doi.org/10.1016/j.chest.2016.08.1474 Get rights and content

Background

The trends of COPD mortality and prevalence over the past 2 decades across all provinces remain unknown in China. We used data from the Global Burden of Disease Study 2013 (GBD 2013) to estimate the mortality and prevalence of COPD during 1990 to 2013 at a provincial level.

Methods

Following the general analytic strategy used in GBD 2013, we analyzed the age- sex- and province-specific mortality and prevalence of COPD in China. Levels of and trends in COPD mortality and prevalence were assessed for 33 province-level administrative units during 1990 to 2013.

Results

In 2013, there were 910,809 deaths from COPD in China, accounting for 31.1% of the total deaths from COPD in the world. From 1990 to 2013, the age-standardized COPD mortality rate decreased in all provinces, with the highest reduction in Heilongjiang (70.2%) and Jilin (70.0%) and the lowest reduction in Guizhou (26.8%). In 2013, the death rate per 100,000 was highest in Guizhou (196.0) and lowest in Tianjin (34.0) among men and highest in Gansu (141.1) and lowest in Beijing (23.7) among women. The number of COPD cases increased dramatically from 32.4 million in 1990 to 54.8 million in 2013. The age-standardized prevalence rate of COPD remained stable overall and varied little for all provinces.

Conclusions

COPD remains a huge health burden in many western provinces in China. The substantial increase in COPD cases represents an ongoing challenge given the rapidly aging Chinese population. A targeted control and prevention strategy should be developed at a provincial level to reduce the burden caused by COPD.

Section snippets

Methods

The general methods used in the GBD study have been published previously.5, 10, 11, 12, 13 Briefly, the GBD study provided a comprehensive assessment of age-specific, sex-specific, all-cause, and cause-specific mortality rates for all major diseases and injuries for 188 countries from 1990 to 2013. The present study focuses on mortality and the prevalence of COPD in China. The units of analyses for this study are the 33 province-level administrative units, including 31 mainland provinces,

Results

In 2013, there were 910,809 (95% UI, 817,530-1,015,436) deaths from COPD in China, accounting for 31.1% of total deaths from COPD in the world. Although the age-standardized COPD death rate decreased both worldwide and in China from 1990 to 2013, the death rate in China in 2013 was still similar to the global rate in 1990. The proportion of deaths from COPD among all noncommunicable disease (NCD) deaths decreased globally as well as in China. However, COPD accounted for a much larger proportion

Discussion

To our knowledge, our study is the most comprehensive summary of COPD prevalence and mortality at the provincial level in China and represents the most up-to-date and accurate information currently available for health policy makers. In particular, the standardized methods for estimates of COPD metrics used in the GBD study allow us to make comparisons on a global level as well as subnationally within China. Although strong national trends exist for COPD prevalence and mortality, this study

Acknowledgments

Author contributions: C. J. L. M. and M. Z. conceived of the study and are guarantors of the paper. P. Y. prepared the first draft and finalized the manuscript based on comments from all other authors. H. W., T. V., Y. L., and M. N. helped with data analysis and interpretation of the results. Y. L., J. L., S. L., X. Z., and L. W. participated in data preparation and analysis and provided comments on the manuscript. All authors contributed to the analysis and reviewed the manuscript.

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: FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

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Original Research: COPDA Subnational Analysis of Mortality and Prevalence of COPD in China From 1990 to 2013: Findings From the Global Burden of Disease Study 2013

Background

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Acknowledgments

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Original Research: COPD
A Subnational Analysis of Mortality and Prevalence of COPD in China From 1990 to 2013: Findings From the Global Burden of Disease Study 2013