International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study

A (Sonia) Buist, Mary Ann McBurnie, William M. Vollmer, Suzanne Gillespie, Peter Burney, David M. Mannino, Ana MB Menezes, Sean D. Sullivan, Todd A. Lee, Kevin B. Weiss, Robert L. Jensen, Guy B. Marks, Amund Gulsvik, Ewa Nizankowska-Mogilnicka

Research output: Contribution to journalArticle

1374 Citations (Scopus)

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a growing cause of morbidity and mortality worldwide, and accurate estimates of the prevalence of this disease are needed to anticipate the future burden of COPD, target key risk factors, and plan for providing COPD-related health services. We aimed to measure the prevalence of COPD and its risk factors and investigate variation across countries by age, sex, and smoking status. Methods: Participants from 12 sites (n=9425) completed postbronchodilator spirometry testing plus questionnaires about respiratory symptoms, health status, and exposure to COPD risk factors. COPD prevalence estimates based on the Global Initiative for Chronic Obstructive Lung Disease staging criteria were adjusted for the target population. Logistic regression was used to estimate adjusted odds ratios (ORs) for COPD associated with 10-year age increments and 10-pack-year (defined as the number of cigarettes smoked per day divided by 20 and multiplied by the number of years that the participant smoked) increments. Meta-analyses provided pooled estimates for these risk factors. Findings: The prevalence of stage II or higher COPD was 10·1% (SE 4·8) overall, 11·8% (7·9) for men, and 8·5% (5·8) for women. The ORs for 10-year age increments were much the same across sites and for women and men. The overall pooled estimate was 1·94 (95% CI 1·80-2·10) per 10-year increment. Site-specific pack-year ORs varied significantly in women (pooled OR=1·28, 95% CI 1·15-1·42, p=0·012), but not in men (1·16, 1·12-1·21, p=0·743). Interpretation: This worldwide study showed higher levels and more advanced staging of spirometrically confirmed COPD than have typically been reported. However, although age and smoking are strong contributors to COPD, they do not fully explain variations in disease prevalence-other factors also seem to be important. Although smoking cessation is becoming an increasingly urgent objective for an ageing worldwide population, a better understanding of other factors that contribute to COPD is crucial to assist local public-health officials in developing the best possible primary and secondary prevention policies for their regions.

Original languageEnglish (US)
Pages (from-to)741-750
Number of pages10
JournalLancet
Volume370
Issue number9589
DOIs
StatePublished - Sep 1 2007

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Chronic Obstructive Pulmonary Disease
Cross-Sectional Studies
Population
Odds Ratio
Smoking
Health Services Needs and Demand
Spirometry
Smoking Cessation
Primary Prevention
Secondary Prevention
Tobacco Products
Health Status
Health Services
Meta-Analysis
Public Health
Logistic Models
Morbidity
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Buist, A. S., McBurnie, M. A., Vollmer, W. M., Gillespie, S., Burney, P., Mannino, D. M., ... Nizankowska-Mogilnicka, E. (2007). International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study. Lancet, 370(9589), 741-750. https://doi.org/10.1016/S0140-6736(07)61377-4

International variation in the prevalence of COPD (The BOLD Study) : a population-based prevalence study. / Buist, A (Sonia); McBurnie, Mary Ann; Vollmer, William M.; Gillespie, Suzanne; Burney, Peter; Mannino, David M.; Menezes, Ana MB; Sullivan, Sean D.; Lee, Todd A.; Weiss, Kevin B.; Jensen, Robert L.; Marks, Guy B.; Gulsvik, Amund; Nizankowska-Mogilnicka, Ewa.

In: Lancet, Vol. 370, No. 9589, 01.09.2007, p. 741-750.

Research output: Contribution to journalArticle

Buist, AS, McBurnie, MA, Vollmer, WM, Gillespie, S, Burney, P, Mannino, DM, Menezes, AMB, Sullivan, SD, Lee, TA, Weiss, KB, Jensen, RL, Marks, GB, Gulsvik, A & Nizankowska-Mogilnicka, E 2007, 'International variation in the prevalence of COPD (The BOLD Study): a population-based prevalence study', Lancet, vol. 370, no. 9589, pp. 741-750. https://doi.org/10.1016/S0140-6736(07)61377-4
Buist, A (Sonia) ; McBurnie, Mary Ann ; Vollmer, William M. ; Gillespie, Suzanne ; Burney, Peter ; Mannino, David M. ; Menezes, Ana MB ; Sullivan, Sean D. ; Lee, Todd A. ; Weiss, Kevin B. ; Jensen, Robert L. ; Marks, Guy B. ; Gulsvik, Amund ; Nizankowska-Mogilnicka, Ewa. / International variation in the prevalence of COPD (The BOLD Study) : a population-based prevalence study. In: Lancet. 2007 ; Vol. 370, No. 9589. pp. 741-750.
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AU - Vollmer, William M.

AU - Gillespie, Suzanne

AU - Burney, Peter

AU - Mannino, David M.

AU - Menezes, Ana MB

AU - Sullivan, Sean D.

AU - Lee, Todd A.

AU - Weiss, Kevin B.

AU - Jensen, Robert L.

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N2 - Background: Chronic obstructive pulmonary disease (COPD) is a growing cause of morbidity and mortality worldwide, and accurate estimates of the prevalence of this disease are needed to anticipate the future burden of COPD, target key risk factors, and plan for providing COPD-related health services. We aimed to measure the prevalence of COPD and its risk factors and investigate variation across countries by age, sex, and smoking status. Methods: Participants from 12 sites (n=9425) completed postbronchodilator spirometry testing plus questionnaires about respiratory symptoms, health status, and exposure to COPD risk factors. COPD prevalence estimates based on the Global Initiative for Chronic Obstructive Lung Disease staging criteria were adjusted for the target population. Logistic regression was used to estimate adjusted odds ratios (ORs) for COPD associated with 10-year age increments and 10-pack-year (defined as the number of cigarettes smoked per day divided by 20 and multiplied by the number of years that the participant smoked) increments. Meta-analyses provided pooled estimates for these risk factors. Findings: The prevalence of stage II or higher COPD was 10·1% (SE 4·8) overall, 11·8% (7·9) for men, and 8·5% (5·8) for women. The ORs for 10-year age increments were much the same across sites and for women and men. The overall pooled estimate was 1·94 (95% CI 1·80-2·10) per 10-year increment. Site-specific pack-year ORs varied significantly in women (pooled OR=1·28, 95% CI 1·15-1·42, p=0·012), but not in men (1·16, 1·12-1·21, p=0·743). Interpretation: This worldwide study showed higher levels and more advanced staging of spirometrically confirmed COPD than have typically been reported. However, although age and smoking are strong contributors to COPD, they do not fully explain variations in disease prevalence-other factors also seem to be important. Although smoking cessation is becoming an increasingly urgent objective for an ageing worldwide population, a better understanding of other factors that contribute to COPD is crucial to assist local public-health officials in developing the best possible primary and secondary prevention policies for their regions.

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