Trends of COPD in Spain: Changes Between Cross Sectional Surveys 1997, 2007 and 2017

• Published in: Archivos de bronconeumología (English ed.) Vol. 59; no. 3; pp. 142 - 151
• Main Authors: García Castillo, Elena, Alonso Pérez, Tamara, Peláez, Adrián, Pérez González, Patricia, Miravitlles, Marc, Alfageme, Inmaculada, Casanova, Ciro, Cosío, Borja G., de Lucas, Pilar, García-Río, Francisco, Rodríguez González-Moro, José Miguel, Soler-Cataluña, Juan José, Sánchez, Guadalupe, Soriano, Joan B., Ancochea, Julio
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España, S.L.U 01.03.2023
• Subjects: COPD; Cross-Sectional Studies; Female; Forced Expiratory Volume; Humans; Male; Prevalence; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary/Respiratory; Risk Factors; Smoking; Spain; Spirometry; Underdiagnosis; Vital Capacity; Spain; Spirometry; Prevalence; Underdiagnosis; COPD; Spain; Smoking
• ISSN: 0300-2896; 1579-2129; 1579-2129
• DOI: 10.1016/j.arbres.2022.11.014

[Display omitted] We aim to describe the changes in prevalence and risk factors associated to chronic obstructive pulmonary disease (COPD) in Spain, comparing three population-based studies conducted in three timepoints. We compared participants from IBERPOC conducted in 1997, EPISCAN conducted in 2007 and EPISCAN II in 2017. COPD was defined as a postbronchodilator FEV1/FVC (forced expiratory volume in 1s/forced vital capacity) ratio <0.70, according to GOLD criteria; subsequently, also as the FEV1/FVC below the lower limit of normal (LLN). COPD prevalence in the population between 40 and 69 years decreased from 21.6% (95% CI 20.7%–23.2%) in 1997 to 8.8% (95% CI 8.2%–9.5%) in 2017, a 59.2% decline (p<0.001). In 2007, the prevalence was 7.7% (95% CI 6.8%–8.7%) with an upward trend of 1.1 percentage points in 2017 (p=0.073). Overall COPD prevalence decreased in men and women, although a significant increase was observed in the last decade in females (p<0.05). Current smokers significantly increased in the last decades (25.4% in 1997, 29.1% in 2007 and 23.4% in 2017; p<0.001). Regrettably, COPD underdiagnosis was constantly high, 77.6% in 1997, 78.4% in 2007, and to 78.2% in 2017 (p=0.95), higher in younger ages (40–49 yrs and 50–59 yrs) and also higher in women than in men in all three studies (p<0.05). We report a significant reduction of 59.2% in the prevalence of COPD in Spain from 1997 to 2017 in subjects aged 40–69 years. Our study highlights the significant underdiagnosis of COPD, particularly sustained in women and younger populations.