Epidemiology

COPD is the third leading cause of death worldwide, causing 3.23 million deaths in 2019, with 90% of deaths in low- and middle-income countries.[1][9][10][11][12]​​​​​​​​​​​​​​​ Globally, deaths from COPD increased by 23% from 1990 to 2017 and COPD and related deaths are estimated to increase to 5.4 million by 2060.[1][13]​​​​​​​ COPD is more common in older people, especially those ages 65 years and older.[14]​ The prevalence of COPD in the US was estimated at 14% postbronchodilator test results based on data from 2007 to 2010.[15] The death rate due to COPD in the US increased over 100% between 1969 and 2013.[16]​ A 2019 National Health Interview Survey revealed that the prevalence of COPD in US adults was greater in those living in non-metropolitan areas than in metropolitan areas, at 8.0% and 4.0%, respectively.[17] COPD prevalence is highest in the World Health Organization region of the Americas and lowest in the South-East Asia and Western Pacific regions. The pooled global prevalence is 15.7% in men and 9.93% in women.[18]

Previously, most studies reported that the prevalence and mortality of COPD are greater in men than in women.[13] However, data from 2012 to 2013 from developed countries suggest that COPD prevalence is now almost equal in men and women, probably due to different patterns of cigarette smoking.[19] Some studies have also suggested that women may have a greater risk of airflow obstruction than men despite exposure to a similar dose of tobacco.[20]

An international study reported that the prevalence of COPD in never-smokers is 12.2%.[21] This may be due to air pollution or indoor burning of solid fuels in low- and middle-income countries. In the US, the prevalence of COPD in never-smokers is 2.2%. Many of these cases are attributed to workplace exposures such as in the mining industry and in food preparation and serving.[22][23]

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