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

• Elena García Castillo ^[1] ; Tamara Alonso Pérez ^[1] ; Adrián Peláez ^[1] ; Patricia Pérez González ^[1] ; Marc Miravitlles ^[5] ; Inmaculada Alfageme ^[2] ; Ciro Casanova ^[3] ; Borja G. Cosío ^[6] ; Pilar de Lucas ^[7] ; Francisco García-Río ^[8] ; José Miguel Rodríguez González-Moro ^[9] ; Juan José Soler-Cataluña ^[4] ; Guadalupe Sánchez ^[10] ; Joan B. Soriano ^[1] ; Julio Ancochea ^[1]
  1. [1] Hospital Universitario de la Princesa

     Hospital Universitario de la Princesa

     Madrid, España

     
  2. [2] Hospital Universitario de Valme

     Hospital Universitario de Valme

     Sevilla, España

     
  3. [3] Hospital Universitario Nuestra Señora de Candelaria

     Hospital Universitario Nuestra Señora de Candelaria

     Santa Cruz de Tenerife, España

     
  4. [4] Universitat de València

     Universitat de València

     Valencia, España

     
  5. [5] Servicio de Pulmonar, Hospital Universitari Vall d’Hebron-CIBERES, Barcelona, España
  6. [6] Departamento de Neumología, Hospital Universitario Son Espases-IdISBa-Ciberes, Palma de Mallorca, Baleares, España
  7. [7] Servicio de Pulmonar, Hospital General Gregorio Marañón, Madrid, España
  8. [8] Servicio de Neumología, Hospital Universitario La Paz-IdiPAZ-CIBERES, Madrid, España
  9. [9] Servicio de Pulmonar, Hospital Universitario de Alcalá de Henares, Madrid, España
  10. [10] Departamento Médico, GSK, Tres Cantos, Madrid, España

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• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 59, Nº. 3 (March), 2023, págs. 142-151
• Idioma: inglés
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• Resumen

  • Introduction 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.

    Methods 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 1 s/forced vital capacity) ratio <0.70, according to GOLD criteria; subsequently, also as the FEV1/FVC below the lower limit of normal (LLN).

    Results 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).

    Conclusions 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.