Trends in Chronic Obstructive Pulmonary Disease Prevalence, Incidence, and Mortality in Ontario, Canada, 1996 to 2007

Background: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease with a prevalence of more than 10% worldwide among adults 40 years and older. Whether this amount has been increasing, decreasing, or stable over time remains unknown. Methods: A longitudinal cohort study using population-based, health administrative data from 1991. to 2007 was conducted in Ontario, Canada. Individuals with COPD were identified using a previously validated health administrative case definition of COPD. Annual COPD prevalence, incidence, and all-cause mortality rates were estimated from 1996 to 2007. Results: The prevalence of COPD increased by 64.8% between 1996 and 2007. The age- and sex-standardizedCOPD prevalence rate increased from 7.8% to 9.5%, representing a relative increase of 23.0% (P <.001). The age- and sex-standardized incidence decreased from 11.8 per 1000 adults to 8.5 per 1000 adults, representing a relative decrease of 28.3% (P<.001). Finally, the age- and sex-standardized all-cause mortality rate decreased from 5.7% to 4.3%, representing a relative decrease of 24.0% (P<.001). Conclusions: Our findings indicate a substantial increase in COPD prevalence in the last decade, with more of the burden being shifted from men to women. Effective clinical and public health strategies are needed to prevent COPD and manage the increasing number of people living longer with this disease.