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Estimating the prevalence of COPD in Canada: Reported diagnosis versus measured airflow obstruction
Jessica Evans1, Yue Chen2, Pat G Camp3
1formerly with the Public Health Agency of Canada, Ottawa, Ontario.
Background:
Estimates of chronic obstructive pulmonary disease (COPD) prevalence based on self-reports of a diagnosis are thought to underestimate the prevalence of COPD in Canada.
Data And Methods:
Pre-bronchodilator spirometry measures were obtained from the 2007 to 2009 Canadian Health Measures Survey for 2,487 individuals aged 35 to 79. The prevalence of self-reported chronic bronchitis symptoms and self-reported diagnosis of COPD by a health care professional was compared with the prevalence of measured airflow obstruction according to seven definitions, including the Global Initiative for Obstructive Lung Disease (GOLD) criteria.
Results:
The prevalence of measured airflow obstruction compatible with COPD was two to six times greater than estimates based on self-reports of a diagnosis. An estimated 16.6% (95% CI: 14.3%-18.9%) of people aged 35 to 79 had pre-bronchodilator airflow obstruction as defined by ≥ GOLD stage I, and 8.1% (95% CI: 6.0%-10.2%) had ≥ GOLD stage II.
Interpretation:
This study suggests that the prevalence of COPD in Canada has been underestimated.
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