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Geographic Variations in Prevalence and Underdiagnosis of COPD.
- Source :
-
CHEST . Oct2000, Vol. 118 Issue 4, p981. 9p. 1 Diagram, 5 Charts, 1 Map. - Publication Year :
- 2000
-
Abstract
- Objectives: To ascertain the prevalence, diagnostic level, and treatment of COPD in Spain through a multicenter study comprising seven different geographic areas. Design and participants: This is an epidemiologic, multicenter, population-based study conducted in seven areas of Spain. A total of 4,035 men and women (age range, 40 to 69 years) who were randomly selected from a target population of 236,412 subjects participated in the study. Interventions: Eligible subjects answered the European Commission for Steel and Coal questionnaire. Spirometry was performed, followed by a bronchodilator test when bronchial obstruction was present. Results: The prevalence of COPD was 9.1% (95% confidence interval [CI], 8.1 to 10.2%), 15% in smokers (95% CI, 12.8 to 17.1%), 12.8% in ex-smokers (95% CI, 10.7 to 14.8%), and 4.1% in nonsmokers (95% CI, 3.3 to 5.1%). The prevalence in men was 14.3% (95% CI, 12.8 to 15.9%) and 3.9% in women (95% CI, 3.1 to 4.8%). Marked differences were observed between sexes in smoking; the percentage of nonsmokers was 23% in men and 76.3% in women (p < 0.0001). The prevalence of COPD varied among the areas, ranging from 4.9% (95% CI, 3.2 to 7.0%) in the area of the lowest prevalence to 18% (95% CI, 14.8 to 21.2%) in the area of the highest. There was no previous diagnosis of COPD in 78.2% of cases (284 of 363). Only 49.3% of patients with severe COPD, 11.8% of patients with moderate COPD, and 10% of patients with mild COPD were receiving some kind of treatment for COPD. Multivariate analysis showed that individuals had a higher probability of having received a previous diagnosis of COPD if they lived in urban areas, were of male gender, were > 60 years old, had higher educational levels, had > 15 pack-year smoking history, or had symptoms of chronic bronchitis. Conclusions: COPD is a very frequent disease in Spain, and presents significant geographic variations and a very Iow level of previous diagnosis and treatment, even in the most advanced cases. [ABSTRACT FROM AUTHOR]
- Subjects :
- *OBSTRUCTIVE lung diseases
*EPIDEMIOLOGY
Subjects
Details
- Language :
- English
- ISSN :
- 00123692
- Volume :
- 118
- Issue :
- 4
- Database :
- Academic Search Index
- Journal :
- CHEST
- Publication Type :
- Academic Journal
- Accession number :
- 11004954
- Full Text :
- https://doi.org/10.1378/chest.118.4.981