COPD mortality rates declining, but total deaths increasing

COPD mortality rates have declined from 1995 to 2017 in many countries. Still, the total number of deaths attributable to COPD has increased during the past 20 years, according to new data published in the European Respiratory Journal.

The existing COPD mortality data were based on outdated statistics from a select number of high-income countries in Europe, Australia, Japan and the U.S., says Joannie Lortet-Tieulent, Ph.D., a research fellow at the WHO International Agency for Research on Cancer.

Using COPD data recorded from 1995 to 2017 from the WHO mortality database, the researchers evaluated death counts according to age, sex, and year. Nearly 3.36 million COPD deaths from 24 countries were included in the analysis.

The researchers calculated COPD death rates by comparing the number of COPD deaths per year against the population of each country in the same year and standardized the data using a reference population. Additionally, they restricted their analysis to people aged 50 to 84 years.

Results revealed a 12% decrease — from 68 deaths per 100,000 person-years to 60 deaths per 100,000 person-years — in the combined COPD death rate for all countries from 2000 to 2015. But there also was a 12% increase in the number of total deaths for all countries from 180,950 to 203,090 estimated total COPD deaths.

Researchers think data suggests that the proportion of COPD patients who are dying early because the disease is falling overall, which is encouraging. Perhaps people are less exposed to COPD risk factors now, and that COPD is being managed more effectively.

Despite the general trend toward lower COPD mortality rates in 18 of the 24 countries examined during the study period, mortality rates overall were still twice as high in men than in women. The exceptions were in the United States, New Zealand and the United Kingdom, where rates were similar for both sexes.

“Our study does not explain why COPD death rates among women increased or remained stable in some countries, but we think this trend could be linked to the rise in the uptake of smoking among women over successive generations, as smoking is an important risk factor for COPD,” Lortet-Tieulent said. "In the countries where women have been smoking as much and for as long as men, such as the U.S., New Zealand, and the U.K., the female COPD death rate became very similar to that of men over time."

The researchers noted, though, that their results likely underestimate the burden of COPD mortality and that more data from low-income countries are necessary.

For additional information detailed in the report, visit Healio.