Decreased COPD prevalence in Sweden after decades of decrease in smoking
Abstract Background COPD has increased in prevalence worldwide over several decades until the first decade after the millennium shift. Evidence from a few recent population studies indicate that the prevalence may be levelling or even decreasing in some areas in Europe. Since the 1970s, a substantia...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-10-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12931-020-01536-4 |
| _version_ | 1818401049263734784 |
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| author | Helena Backman Lowie Vanfleteren Anne Lindberg Linda Ekerljung Caroline Stridsman Malin Axelsson Ulf Nilsson Bright I. Nwaru Sami Sawalha Berne Eriksson Linnea Hedman Madeleine Rådinger Sven-Arne Jansson Anders Ullman Hannu Kankaanranta Jan Lötvall Eva Rönmark Bo Lundbäck |
| author_facet | Helena Backman Lowie Vanfleteren Anne Lindberg Linda Ekerljung Caroline Stridsman Malin Axelsson Ulf Nilsson Bright I. Nwaru Sami Sawalha Berne Eriksson Linnea Hedman Madeleine Rådinger Sven-Arne Jansson Anders Ullman Hannu Kankaanranta Jan Lötvall Eva Rönmark Bo Lundbäck |
| author_sort | Helena Backman |
| collection | DOAJ |
| description | Abstract Background COPD has increased in prevalence worldwide over several decades until the first decade after the millennium shift. Evidence from a few recent population studies indicate that the prevalence may be levelling or even decreasing in some areas in Europe. Since the 1970s, a substantial and ongoing decrease in smoking prevalence has been observed in several European countries including Sweden. The aim of the current study was to estimate the prevalence, characteristics and risk factors for COPD in the Swedish general population. A further aim was to estimate the prevalence trend of COPD in Northern Sweden from 1994 to 2009. Methods Two large random population samples were invited to spirometry with bronchodilator testing and structured interviews in 2009–2012, one in south-western and one in northern Sweden, n = 1839 participants in total. The results from northern Sweden were compared to a study performed 15 years earlier in the same area and age-span. The diagnosis of COPD required both chronic airway obstruction (CAO) and the presence of respiratory symptoms, in line with the GOLD documents since 2017. CAO was defined as post-bronchodilator FEV1/FVC < 0.70, with sensitivity analyses based on the FEV1/FVC < lower limit of normal (LLN) criterion. Results Based on the fixed ratio definition, the prevalence of COPD was 7.0% (men 8.3%; women 5.8%) in 2009–2012. The prevalence of moderate to severe (GOLD ≥ 2) COPD was 3.5%. The LLN based results were about 30% lower. Smoking, occupational exposures, and older age were risk factors for COPD, whereof smoking was the most dominating risk factor. In northern Sweden the prevalence of COPD, particularly moderate to severe COPD, decreased significantly from 1994 to 2009, and the decrease followed a decrease in smoking. Conclusions The prevalence of COPD has decreased in Sweden, and the prevalence of moderate to severe COPD was particularly low. The decrease follows a major decrease in smoking prevalence over several decades, but smoking remained the dominating risk factor for COPD. |
| first_indexed | 2024-12-14T07:46:17Z |
| format | Article |
| id | doaj.art-daaf0122252b472ba1a938d10b2a029b |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-14T07:46:17Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-daaf0122252b472ba1a938d10b2a029b2022-12-21T23:10:53ZengBMCRespiratory Research1465-993X2020-10-0121111210.1186/s12931-020-01536-4Decreased COPD prevalence in Sweden after decades of decrease in smokingHelena Backman0Lowie Vanfleteren1Anne Lindberg2Linda Ekerljung3Caroline Stridsman4Malin Axelsson5Ulf Nilsson6Bright I. Nwaru7Sami Sawalha8Berne Eriksson9Linnea Hedman10Madeleine Rådinger11Sven-Arne Jansson12Anders Ullman13Hannu Kankaanranta14Jan Lötvall15Eva Rönmark16Bo Lundbäck17Department of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå UniversityCOPD Center, Sahlgrenska University Hospital, University of GothenburgDept of Public Health and Clinical Medicine, Section of Medicine, Umeå UniversityKrefting Research Centre, Institute of Medicine, University of GothenburgDept of Public Health and Clinical Medicine, Section of Medicine, Umeå UniversityDepartment of Care Science, Faculty of Health and Society, Malmö UniversityDept of Public Health and Clinical Medicine, Section of Medicine, Umeå UniversityKrefting Research Centre, Institute of Medicine, University of GothenburgDept of Public Health and Clinical Medicine, Section of Medicine, Umeå UniversityKrefting Research Centre, Institute of Medicine, University of GothenburgDepartment of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå UniversityKrefting Research Centre, Institute of Medicine, University of GothenburgDepartment of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå UniversityCOPD Center, Sahlgrenska University Hospital, University of GothenburgKrefting Research Centre, Institute of Medicine, University of GothenburgKrefting Research Centre, Institute of Medicine, University of GothenburgDepartment of Public Health and Clinical Medicine, Section of Sustainable Health/the OLIN Unit, Umeå UniversityKrefting Research Centre, Institute of Medicine, University of GothenburgAbstract Background COPD has increased in prevalence worldwide over several decades until the first decade after the millennium shift. Evidence from a few recent population studies indicate that the prevalence may be levelling or even decreasing in some areas in Europe. Since the 1970s, a substantial and ongoing decrease in smoking prevalence has been observed in several European countries including Sweden. The aim of the current study was to estimate the prevalence, characteristics and risk factors for COPD in the Swedish general population. A further aim was to estimate the prevalence trend of COPD in Northern Sweden from 1994 to 2009. Methods Two large random population samples were invited to spirometry with bronchodilator testing and structured interviews in 2009–2012, one in south-western and one in northern Sweden, n = 1839 participants in total. The results from northern Sweden were compared to a study performed 15 years earlier in the same area and age-span. The diagnosis of COPD required both chronic airway obstruction (CAO) and the presence of respiratory symptoms, in line with the GOLD documents since 2017. CAO was defined as post-bronchodilator FEV1/FVC < 0.70, with sensitivity analyses based on the FEV1/FVC < lower limit of normal (LLN) criterion. Results Based on the fixed ratio definition, the prevalence of COPD was 7.0% (men 8.3%; women 5.8%) in 2009–2012. The prevalence of moderate to severe (GOLD ≥ 2) COPD was 3.5%. The LLN based results were about 30% lower. Smoking, occupational exposures, and older age were risk factors for COPD, whereof smoking was the most dominating risk factor. In northern Sweden the prevalence of COPD, particularly moderate to severe COPD, decreased significantly from 1994 to 2009, and the decrease followed a decrease in smoking. Conclusions The prevalence of COPD has decreased in Sweden, and the prevalence of moderate to severe COPD was particularly low. The decrease follows a major decrease in smoking prevalence over several decades, but smoking remained the dominating risk factor for COPD.http://link.springer.com/article/10.1186/s12931-020-01536-4COPDPrevalenceRiskPopulation studyEpidemiology |
| spellingShingle | Helena Backman Lowie Vanfleteren Anne Lindberg Linda Ekerljung Caroline Stridsman Malin Axelsson Ulf Nilsson Bright I. Nwaru Sami Sawalha Berne Eriksson Linnea Hedman Madeleine Rådinger Sven-Arne Jansson Anders Ullman Hannu Kankaanranta Jan Lötvall Eva Rönmark Bo Lundbäck Decreased COPD prevalence in Sweden after decades of decrease in smoking Respiratory Research COPD Prevalence Risk Population study Epidemiology |
| title | Decreased COPD prevalence in Sweden after decades of decrease in smoking |
| title_full | Decreased COPD prevalence in Sweden after decades of decrease in smoking |
| title_fullStr | Decreased COPD prevalence in Sweden after decades of decrease in smoking |
| title_full_unstemmed | Decreased COPD prevalence in Sweden after decades of decrease in smoking |
| title_short | Decreased COPD prevalence in Sweden after decades of decrease in smoking |
| title_sort | decreased copd prevalence in sweden after decades of decrease in smoking |
| topic | COPD Prevalence Risk Population study Epidemiology |
| url | http://link.springer.com/article/10.1186/s12931-020-01536-4 |
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