Trends in mortality from COPD among adults in the United States.

BACKGROUND COPD imposes a large public health burden internationally and in the United States. The objective of this study was to examine trends in mortality from COPD among US adults from 1968 to 2011. METHODS Data from the National Vital Statistics System from 1968 to 2011 for adults aged ≥ 25 years were accessed, and trends in mortality rates were examined with Joinpoint analysis. RESULTS Among all adults, age-adjusted mortality rate rose from 29.4 per 100,000 population in 1968 to 67.0 per 100,000 population in 1999 and then declined to 63.7 per 100,000 population in 2011 (annual percentage change [APC] 2000-2011, -0.2%; 95% CI, -0.6 to 0.2). The age-adjusted mortality rate among men peaked in 1999 and then declined (APC 1999-2011, -1.1%; 95% CI, -1.4 to -0.7), whereas the age-adjusted mortality rate among women increased from 2000 to 2011, peaking in 2008 (APC 2000-2011, 0.4%; 95% CI, 0.0-0.9). Despite a narrowing of the sex gap, mortality rates in men continued to exceed those in women. Evidence of a decline in the APC was noted for black men (1999-2011, -1.5%; 95% CI, -2.1 to -1.0) and white men (1999-2011, -0.9%; 95% CI, -1.3 to -0.6), adults aged 55 to 64 years (1989-2011, -1.0%; 95% CI, -1.2 to -0.8), and adults aged 65 to 74 years (1999-2011, -1.2%; 95% CI, -1.6 to -0.9). CONCLUSIONS In the United States, the mortality rate from COPD has declined since 1999 in men and some age groups but appears to be still rising in women, albeit at a reduced pace.

[1]  J. Soriano,et al.  Mortality trends in chronic obstructive pulmonary disease in Europe, 1994-2010: a joinpoint regression analysis. , 2014, The Lancet. Respiratory medicine.

[2]  B. Lushniak,et al.  The Health consequences of smoking—50 years of progress : a report of the Surgeon General , 2014 .

[3]  D. Mannino,et al.  Trends in the prevalence of obstructive and restrictive lung function among adults in the United States: findings from the National Health and Nutrition Examination surveys from 1988-1994 to 2007-2010. , 2013, Chest.

[4]  D. Mannino,et al.  COPD Surveillance—United States, 1999-2011 , 2013, Chest.

[5]  Bernadette A. Thomas,et al.  Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[6]  S. Matsuda,et al.  Age-Period-Cohort Analysis of Chronic Obstructive Pulmonary Disease Mortality in Japan, 1950–2004 , 2012, Journal of epidemiology.

[7]  Jiaquan Xu,et al.  Deaths: final data for 2008. , 2011, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[8]  L. Akinbami,et al.  Chronic obstructive pulmonary disease among adults aged 18 and over in the United States, 1998-2009. , 2011, NCHS data brief.

[9]  A. Jemal,et al.  Trends in the leading causes of death in the United States, 1970-2002. , 2005, JAMA.

[10]  D. Mannino,et al.  Sex differences in COPD and lung cancer mortality trends--United States, 1968-1999. , 2004, Journal of women's health.

[11]  D. Mannino,et al.  Chronic obstructive pulmonary disease surveillance--United States, 1971-2000. , 2002, Respiratory care.

[12]  H M Rosenberg,et al.  Comparability of cause of death between ICD-9 and ICD-10: preliminary estimates. , 2001, National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System.

[13]  E. Feuer,et al.  Permutation tests for joinpoint regression with applications to cancer rates. , 2000, Statistics in medicine.

[14]  Alan D. Lopez,et al.  Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study , 1997, The Lancet.

[15]  M. Lebowitz,et al.  Death certificate reporting of confirmed airways obstructive disease. , 1991, American journal of epidemiology.

[16]  G. Dart,et al.  The causes of death in chronic airway obstruction. I. The unreliability of death certificates and routine autopsies. , 1968, The American review of respiratory disease.