Purpose: To describe trends in the epidemiology of COPD
in Canada from 1980 to 1995, in terms of perceived prevalence,
mortality, and hospital morbidity.
Data sources: We
limited the analysis to data related to chronic bronchitis, emphysema,
or chronic airway obstruction not classified elsewhere, and excluded
asthma (Ninth International Classification of Diseases, codes 490 to
492 and 496). The perceived prevalence rate of COPD was derived from
the 1994–1995 National Health Survey. Mortality and hospital morbidity
data (from 1980 to 1995) were obtained from the Health Statistics
Division of Statistics Canada.
Results: From the
National Health Survey, it was estimated that 750,000 Canadians had
chronic bronchitis or emphysema diagnosed by a health professional.
Prevalence rates were the following: ages 55 to 64 years, 4.6%; ages
65 to 74 years, 5.0%; ≥ 75 years, 6.8%. From 1980 to 1995, the
total number of deaths from COPD increased from 4,438 to 8,583.
Although the age-standardized mortality rate remained stable throughout
this period in men (around 45/100,000 population), it doubled in women
(8.3/100,000 in 1980 to 17.3/100,000 in 1995). There were 55,782
hospital separations in 1993–1994 with COPD as the primary discharge
diagnosis (compared to 42,102 in 1981–1982). In people aged ≥ 65
years, the age-specific hospital separation rate increased over this
period, especially in women ≥ 75 years (from 504/100,000 to
1,033/100,000). The average in-hospital length of stay was 9.6 days in
1981–1982 and 8.3 days in 1993–1994.
COPD represents a major health issue in Canada and will likely remain
so for decades. Physician and non-physician health professionals who
provide health care, as well as those who fund it must actively
encourage approaches for primary and secondary prevention of this
condition as well as approaches shown to be effective in addressing its
associated impairment, disability, and handicap.