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Trends in COPD mortality and hospitalizations in countries and regions of Asia-Pacific


  • Conflicts of interest: Wan C. Tan has received research grants from GlaxoSmithKline, AstraZeneca and Boehringer/Pfizer for the epidemiological study of COPD in Canada. P Seale of the Clinical Trials Unit of the Woolcock Institute of Medical Research, Sydney has conducted clinical trials which are funded by the following pharmaceutical companies: GlaxoSmithKline, AstraZeneca, Nycomed, Pfizer, Boehringer Ingelheim, Novartis and Almirall. The other authors have no conflict of interest to declare. Boehringer Ingelhiem and Pfizer provided the funds for professional help in statistical analysis and in editing of the manuscript, but were not involved in the data collection, the interpretation of the data or writing of the manuscript.

Wan C. Tan, UBC James Hogg iCAPTURE Centre, St Paul's Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6. Email:


Background and objective:  The growing burden of COPD in the Asia-Pacific region supports the need for more intensive research and analysis of the epidemiology of COPD to raise awareness of the disease and its causes, to ensure the development of effective national health policies and to facilitate equitable deployment of finite health-care resources in the prevention and management of COPD. This study estimated and compared COPD mortality and hospital morbidity rates and trends in these rates over time across countries and regions of Asia-Pacific.

Methods:  Data consistent with standard definitions of COPD (ICD-9/ICD-10) for the period 1991–2004 were obtained from national health statistics agencies. For countries/regions with complete national mortality and hospitalization data (Australia, Pacific Canada (British Columbia, Hong Kong, South Korea and Taiwan), annual age-standardized mortality and hospitalization rates were calculated for men and women aged ≥ 40 years. Negative binomial regression modelling was used to estimate rate ratios for country/region, gender and age differences and general trends over time.

Results:  Mortality rates per 10 000 population ranged 6.4–9.2 in men, 2.1–3.5 in women and 3.7–5.3 overall in 2003. Corresponding ranges for morbidity were 32.6–334.7, 21.2–129 and 28.1–207.3 per 10 000. Trend analysis of data since 1997 produced annual percentage changes in mortality versus hospitalization of −4.4% versus −0.7% in Australia, −3.6% versus 7.5% in Pacific Canada (British Columbia), −7.15% versus −5.6% in Hong Kong and −2.9% versus −4.2% in Taiwan.

Conclusions:  In Asia-Pacific, overall mortality and morbidity rates are high and trends in mortality and morbidity vary between countries/regions. Differences in rates and trends for men and women most likely reflect the different trends in historical and prevalent smoking profiles for COPD in the different countries and regions.