According to the first comprehensive estimate of lifetime risk for chronic obstructive pulmonary disease (COPD) published in a special European Respiratory Society issue of The Lancet, one out of four individuals aged 35 and over are likely to develop COPD at some stage of their lives. The discoveries indicate that people have a much higher risk of developing COPD than congestive heart failure, acute heart attack, and several common cancers.

The results suggest that at some stage of their life, the average woman at 35 years of age is over three times more likely to develop chronic obstructive pulmonary disease compared to breast cancer, and for the average 35 year old man the risk of developing COPD is three times higher than prostate cancer.

By 2030 chronic obstructive pulmonary disease is estimated to be the third most common cause of death worldwide, a leading cause of hospitalizations, as well as being one of the most expensive chronic diseases. However, in comparison to diseases, such as diabetes, there is little public awareness of COPD and the funding, research and profile is not the same as other diseases with a similar burden.

Using population-based health administrative information for the entire population of Ontario (approximately 13 million people), Andrea Gershon from the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada and colleagues aimed to calculate the lifetime risk of developing physician-diagnosed COPD. All people aged between 35 and 80 years old who did not have chronic obstructive pulmonary disease in 1996 were followed up to 14 years. During the investigation, a total of 579,466 cases of COPD were diagnosed.

27.6% (one in four chance) was the overall projected lifetime risk of being diagnosed with COPD by a physician. And in comparison to women (25.6% one in four), men had a higher risk (29.7% almost one in three) of developing COPD. The lifetime risk of getting the disease was also increased by lower socioeconomic status and living in a rural area.

The investigators highlight:

“COPD had a lifetime risk comparable to diabetes and asthma. Its lifetime risk was about double that of congestive heart failure…three to four times that of acute myocardial infarction, breast cancer [in women], and prostate cancer [in men]…and more than seven times that of other cancers.”

They conclude:

“Our novel findings draw attention to the huge burden of COPD on society and can be used to educate the public about the need for attention and resources to combat the disease…[and to] justify the continuation of smoking cessation programs, and the development of other strategies to optimize COPD care to improve the lives of affected individuals, their families, and their communities.”

In a Comment, David Mannino from the University of Kentucky College of Public Health, Lexington, USA and Fernando Martinez from the University of Michigan Health System, Michigan, USA explains that these discoveries are especially important because: “Until recently, there has been little public awareness about COPD and the disease has received few resources from funding agencies. The amount spent on research per case still lags behind that of other chronic and malignant diseases.”

Written by Grace Rattue