Epidemiology of COPD: a European perspective

Mortality rates from chronic obstructive pulmonary disease (COPD) vary across Europe. However, the continuing elevated prevalence rates of current smoking among males and the increasing trend observed in females in the last decades predicts an increase of COPD mortality in many countries in the coming years. The real prevalence of COPD within a given population may vary widely depending upon the tools used for its identification: reported respiratory symptoms, medical diagnosis and abnormal lung function. Even when the diagnosis is based on an objective tool like spirometry, largely variable prevalence rates are found within the same population. In view of the different criteria endorsed by different scientific societies, it is clear that further research is needed to reach a standardised criterion for airways obstruction. Patients underestimate their own morbidity and may therefore be undertreated. The cost of COPD, largely driven by exacerbations, is expected to increase considerably in the future, reflecting the previous smoking habits of an ageing population. The impressive prevalence in current smokers <45 yrs of age in most countries highlights the need to improve the quality of prevention; early detection and screening programmes may be useful in this population of smokers.