The Changing and Predicted Trends in Chronic Obstructive Pulmonary Disease Burden in China, the United States, and India from 1990 to 2030

Abstract

Background

This study analyzed the burden of chronic obstructive pulmonary disease (COPD) in China, the United States, and India from 1990 to 2019 and projected the trends for the next decade.

Methods

This study utilized the GBD 2019 to compare the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), age-standardized disability-adjusted life years (DALYs) rate, and the proportion attributed to different risk factors in China, the United States, and India. Joinpoint models and autoregressive integrated moving average (ARIMA) models were employed to capture the changing trends in disease burden and forecast outcomes.

Results

From 1990 to 2019, China’s age-standardized COPD incidence and mortality rates decreased by 29% and 70%, respectively. In the same period, India’s rates decreased by 8% and 33%, while the United States saw an increase of 9% in COPD incidence and a 22% rise in mortality rates. Smoking and ambient particulate matter pollution are the two most significant risk factors for COPD, while household air pollution from solid fuels and low temperatures are the least impactful factors in the United States and India, respectively. The proportion of risk from household air pollution from solid fuels is higher in India than in China and the United States. Predictions for 2030 suggest that the age-standardized DALY rates, ASIR, and ASMR in the United States and India are expected to remain stable or decrease, while China’s age-standardized incidence rate is projected to rise.

Conclusion

Over the past three decades, the incidence of COPD has been decreasing in China and India, while showing a slight increase in the United States. Smoking and ambient particulate matter pollution are the primary risk factors for men and women, respectively. The risk of household air pollution from solid fuels in India needs attention.

Keywords:

• COPD
• global burden of disease
• risk factors
• DALYs

Data Sharing Statement

This research is based on publicly available data from the Global Burden of Disease Study 2019. The data can be freely downloaded from the IHME data repository (http://ghdx.healthdata.org/gbd-results-tool) without requiring any download permissions.

Ethics Statement

The Ethics Committee of the First Affiliated Hospital of Guangzhou Medical University has granted an exemption from ethical approval, as the Global Burden of Disease Research Database is publicly accessible, and all participant data is based on non-interventional studies and is anonymous.

Acknowledgments

The authors extend their gratitude to the Global Burden of Disease Study team for providing this data, enabling us to conduct our research smoothly. Baojun Guo and Hui Gan should be regard as co-first authors.

Disclosure

The authors declare that this work has no conflicts of interest.

Additional information

Funding

This study was supported by Zhong Nanshan Medical Foundation of Guangdong Province (ZNSXS-20220015).