Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis

Georgios Ntritsos, Jacob Franek, Lazaros Belbasis, Maria A Christou, Georgios Markozannes, Pablo Altman, Robert Fogel, Tobias Sayre, Evangelia E Ntzani, Evangelos Evangelou, Georgios Ntritsos, Jacob Franek, Lazaros Belbasis, Maria A Christou, Georgios Markozannes, Pablo Altman, Robert Fogel, Tobias Sayre, Evangelia E Ntzani, Evangelos Evangelou

Abstract

Rationale: COPD has been perceived as being a disease of older men. However, >7 million women are estimated to live with COPD in the USA alone. Despite a growing body of literature suggesting an increasing burden of COPD in women, the evidence is limited.

Objectives: To assess and synthesize the available evidence among population-based epidemiologic studies and calculate the global prevalence of COPD in men and women.

Materials and methods: A systematic review and meta-analysis reporting gender-specific prevalence of COPD was undertaken. Gender-specific prevalence estimates were abstracted from relevant studies. Associated patient characteristics as well as custom variables pertaining to the diagnostic method and other important epidemiologic covariates were also collected. A Bayesian random-effects meta-analysis was performed investigating gender-specific prevalence of COPD stratified by age, geography, calendar time, study setting, diagnostic method, and disease severity.

Measurements and main results: Among 194 eligible studies, summary prevalence was 9.23% (95% credible interval [CrI]: 8.16%-10.36%) in men and 6.16% (95% CrI: 5.41%-6.95%) in women. Gender prevalences varied widely by the World Health Organization Global Burden of Disease subregions, with the highest female prevalence found in North America (8.07% vs 7.30%) and in participants in urban settings (13.03% vs 8.34%). Meta-regression indicated that age ≥40 and bronchodilator testing contributed most significantly to heterogeneity of prevalence estimates across studies.

Conclusion: We conducted the largest ever systematic review and meta-analysis of global prevalence of COPD and the first large gender-specific review. These results will increase awareness of COPD as a critical woman's health issue.

Keywords: COPD; age; gender; meta-analysis; prevalence; systematic review.

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Summary estimates of prevalence for men and women by severity.
Figure 2
Figure 2
Summary estimates of prevalence for men and women by calendar time.

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