COPD is more common in older people, especially those aged 65 years and older. 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.Varmaghani M, Dehghani M, Heidari E, et al. Global prevalence of chronic obstructive pulmonary disease: systematic review and meta-analysis. East Mediterr Health J. 2019 Mar 19;25(1):47-57.
The prevalence of COPD in the US is estimated at 14%.Tilert T, Dillon C, Paulose-Ram R, et al. Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007-2010. Respir Res. 2013 Oct 9;14:103.
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.QuickStats: percentage of adults aged ≥18 years with diagnosed chronic obstructive pulmonary disease, by urbanization level and age group - National Health Interview Survey, United States, 2019. MMWR Morb Mortal Wkly Rep. 2021 Jul 2;70(26):959.
Prevalence of COPD increased with age regardless of urbanisation level.
Globally, deaths from COPD increased by 23% from 1990 to 2017, and currently there are about 3 million deaths from COPD each year.Li X, Cao X, Guo M, et al. Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ. 2020 Feb 19;368:m234.
The expanding epidemic of smoking and ageing of the world population, as well as the reduced mortality from other causes of death such as cardiovascular disease, mean that by 2060 there may be over 5.4 million deaths per year due to COPD and related diseases.Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: 2023 report [internet publication].
Previously, most studies reported that the prevalence and mortality of COPD are greater in men than women.Li X, Cao X, Guo M, et al. Trends and risk factors of mortality and disability adjusted life years for chronic respiratory diseases from 1990 to 2017: systematic analysis for the Global Burden of Disease Study 2017. BMJ. 2020 Feb 19;368:m234.
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.Landis SH, Muellerova H, Mannino DM, et al. Continuing to Confront COPD International Patient Survey: methods, COPD prevalence, and disease burden in 2012-2013. Int J Chron Obstruct Pulmon Dis. 2014;9:597-611.
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.Han MK. Chronic obstructive pulmonary disease in women: a biologically focused review with a systematic search strategy. Int J Chron Obstruct Pulmon Dis. 2020;15:711-21.
An international study reported that the prevalence of COPD in never-smokers is 12.2%.Lamprecht B, McBurnie MA, Vollmer WM, et al. COPD in never smokers: results from the population-based burden of obstructive lung disease study. Chest. 2011 Apr;139(4):752-63.
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.Syamlal G, Doney B, Mazurek JM. Chronic obstructive pulmonary disease prevalence among adults who have never smoked, by industry and occupation - United States, 2013-2017. MMWR Morb Mortal Wkly Rep. 2019 Apr 5;68(13):303-7.
Syamlal G, Kurth LM, Dodd KE, et al. Chronic obstructive pulmonary disease mortality by industry and occupation: United States, 2020. MMWR Morb Mortal Wkly Rep. 2022 Dec 9;71(49):1550-4.