Data
A high prevalence of COPD
Studies on the prevalence of COPD are rare. Due to the significant underdiagnosis of this disease, it cannot be estimated through questionnaire surveys, and surveys that include lung function testing can be difficult to conduct in the general population. In questionnaire-based surveys, COPD is approximated by chronic bronchitis (defined by the presence of chronic cough and sputum production).
Studies on the prevalence of COPD or chronic bronchitis are briefly summarized here 1,2.
In a French study conducted in the general population in 2000, the prevalence of chronic bronchitis estimated by self-administered questionnaire was 4.1%, or 1.7 million people 3. Data from the INSEE 2003 Decennial Health Survey estimated the prevalence of chronic bronchitis at 3.5% 4.
An international general population survey (Confronting COPD Survey), conducted by telephone in 2000, estimated the prevalence of COPD (defined by a known diagnosis of COPD or chronic bronchitis, or by symptoms of chronic bronchitis) in France at 3.2% of people over 45 years of age who had smoked more than 10 pack-years 5.
In a study conducted at health screening centers (CES) in 2003 that included lung function testing, the prevalence of chronic bronchitis was 3.9% and the prevalence of COPD was 7.5%6.
In the European ECRHS study, the prevalence of COPD and respiratory symptoms (chronic cough or sputum production) in France was among the lowest in Europe. In this study of young adults (ages 20–44), the prevalence of stage 0 of the 2005 GOLD classification (chronic cough or sputum production without obstructive ventilatory disorder) was 9.2% in France, and the prevalence of COPD (stage 1 or higher of the GOLD classification) in this age group was 1.5%.
More recently, a survey conducted in the cities of Lille and Dunkirk revealed a prevalence of obstructive ventilatory disorder ranging from 9.9% to 16.0% depending on the city and the definition of obstructive ventilatory disorder used.
Roche N, Zureik M, Vergnenègre A, Huchon G, Neukirch F. Recent data on the prevalence of chronic obstructive pulmonary disease in France. Bull Epidemiol Hebd 2007;27-28:245-8.
Fuhrman C, Delmas M-C, on behalf of the SPLF Epidemiology and Clinical Research Group. Descriptive epidemiology of chronic obstructive pulmonary disease (COPD) in France. Rev Mal Respir 2010;27:160-8.
Huchon GJ, Vergnenègre A, Neukirch F, Brami G, Roche N, Preux PM. Chronic bronchitis among French adults: high prevalence and underdiagnosis. Eur Respir J 2002;20:806-12.
Fuhrman C, Roche N, Vergnenègre A, Chouaid C, Zureik M, Delmas C. Chronic bronchitis: prevalence and impact on daily life. Analysis of data from the INSEE Health Survey 2002-2003. Saint-Maurice: Institute for Health Surveillance; 2008. 37 p.
Rennard S, Decramer M, Calverley PM, Pride NB, Soriano JB, Vermeire PA et al. Impact of COPD in North America and Europe in 2000: subjects' perspective of the Confronting COPD International Survey. Eur Respir J 2002;20:799-805.
Roche N, Dalmay F, Perez T, Kuntz C, Vergnenègre A, Neukirch F, Giordanella JP, Huchon G. Impact of chronic airflow obstruction in a working population. Eur Respir J 2008:31:1227-33.
De Marco R, Accordini S, Cerveri I, Corsico A, Sunyer J, Neukirch F et al. An international survey of chronic obstructive pulmonary disease in young adults according to GOLD stages. Thorax 2004;59:120-5.
Quach A, Giovannelli J, Cherot-Kornobis N, Ciuchete A, Clement G, Matran R, et al. Prevalence and underdiagnosis of airway obstruction among middle-aged adults in northern France: The ELISABET study 2011-2013. Respir Med 2015;109:1553-61.
Underreported Mortality
Chronic obstructive pulmonary disease (COPD) is generally underreported on death certificates. Indeed, it is an underdiagnosed disease, even in severe stages, and when it is diagnosed, it may not be listed on the death certificate if there are other concurrent causes of death.
In 2014, COPD was listed as a cause of death (primary cause or contributing cause) for more than 18,000 deaths among residents in France (excluding Mayotte). For nearly half of these deaths, COPD was listed as the primary cause of death.
Across all ages and genders, the crude mortality rate from COPD (underlying cause) was 13.0 per 100,000 inhabitants, and the crude mortality rate associated with COPD (multiple causes) was 27.7 per 100,000.
|
|
Mortality from COPD |
Mortality related to COPD |
||||||
|---|---|---|---|---|---|---|---|---|
|
|
Men |
Women |
Men |
Women |
||||
|
Age |
Number |
Rate per 100,000 |
Number |
Rate per 100,000 |
Number |
Rate per 100,000 |
Number |
Rate per 100,000 |
|
0–44 years |
11 |
0.06 |
8 |
0.04 |
26 |
0.14 |
25 |
0.13 |
|
45–64 years |
532 |
6.3 |
218 |
2.5 |
1,370 |
16.3 |
492 |
5.6 |
|
65–84 years |
2,813 |
62.3 |
1,137 |
20.3 |
6,392 |
141.5 |
2,298 |
40.6 |
|
85 years or older |
2,140 |
361.2 |
1,758 |
132.0 |
4,390 |
741.0 |
3,334 |
250.3 |
|
All ages |
5,496 |
17.2 |
3,121 |
9.2 |
12,178 |
38.1 |
6,129 |
18.0 |
Since 2000, COPD mortality rates and COPD-related mortality rates among adults aged 45 and older have been declining among men and have remained stable among women.
Standardized annual rates of COPD mortality and COPD-related mortality among adults aged 45 and older, France (excluding Mayotte), 2000–2014
Regional Variations in Mortality
In 2013–2014, the highest COPD mortality rates were observed in the Hauts-de-France and Grand-Est regions and in Réunion.
Regional variations in COPD mortality (underlying cause of death), difference between the regional age-standardized average rate and the national average rate, adults aged 45 and older, 2013–2014
Hospitalization rates for COPD exacerbations increase with age
In 2015, the number of hospital stays for COPD exacerbations among adults aged 25 or older residing in France (excluding Mayotte) ranged from 100,000 to 150,000 depending on the indicator used, representing a crude hospitalization rate for COPD exacerbations, across all ages and genders, ranging from 15.9 to 24.9 per 100,000 inhabitants.
|
|
Strict definition |
Broad definition |
||||||
|---|---|---|---|---|---|---|---|---|
|
|
Men |
Women |
Men |
Women |
||||
|
Age |
Number |
Rate per 10,000 |
Number |
Rate per 10,000 |
Number |
Rate per 10,000 |
Number |
Rate per 10,000 |
|
0–24 years |
152 |
0.15 |
147 |
0.15 |
371 |
0.36 |
262 |
0.27 |
|
25–44 years |
854 |
1.0 |
629 |
0.7 |
1,284 |
1.8 |
920 |
1.2 |
|
45–64 years |
14,494 |
17.2 |
9,400 |
10.6 |
19,684 |
27.4 |
12,128 |
15.0 |
|
65–84 years |
39,295 |
84.3 |
18,531 |
32.3 |
54,322 |
134.0 |
24,995 |
48.2 |
|
85 years or older |
12,168 |
196.5 |
10,001 |
72.8 |
17,521 |
318.1 |
14,064 |
114.0 |
|
All ages |
66,963 |
20.8 |
38,708 |
11.3 |
107,153 |
33.3 |
57,876 |
16.9 |
An increase in the hospitalization rate for COPD exacerbations between 2000 and 2015
The annual standardized hospitalization rates for COPD exacerbations among adults aged 25 and older increased between 2000 and 2015, among both men and women.
Standardized annual hospitalization rates for COPD exacerbations, adults aged 25 and older, France, 2000–2015
Regional Variation in Hospitalization Rates for COPD Exacerbations
In 2015, Hauts-de-France, the Grand Est region, and Réunion were the regions most affected.
Regional variations in the hospitalization rate for COPD (strict definition), difference between the regional standardized rate and the national rate, adults aged 25 and older, 2015
The prevalence of long-term oxygen therapy (LTOT) increases with age
|
|
Rate per 10,000 |
||
|---|---|---|---|
|
Age |
Men |
Women |
All genders |
|
0–24 years |
1.1 |
1.0 |
1.1 |
|
25–44 |
1.3 |
2.5 |
1.9 |
|
45–64 |
21.4 |
15.3 |
18.4 |
|
65–84 years |
81.9 |
62.4 |
71.4 |
|
85 years and older |
183.3 |
166.1 |
171.6 |
An increase in the prevalence of long-term oxygen therapy (LTOT) among women
Standardized annual prevalence rates of OLD treatment among beneficiaries of the general health insurance scheme (excluding local mutual insurance branches) aged 45 or older, general sample of beneficiaries, 2006–2015
See also
rapport/synthèse
14 June 2019
Analysis of Mortality and Causes of Death by Economic Sector from 1968 to 1999 Using the Permanent Demographic Sample. Study for the Implementation of the Cosmop Program: A Cohort for Monitoring Mortality by Occupation
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