The global burden of COPD: epidemiology and effect of prevention strategies.

Chronic obstructive pulmonary disease (COPD) affects more than 400 million people, continues to be the third cause of death worldwide, and has substantial regional variations in prevalence, risk factors, and temporal trends. COPD is associated with major socioeconomic and health consequences, with low-income and middle-income countries contributing the most to its growing burden. COPD prevalence among women is projected to increase, while that among men will decrease. This difference is possibly because tobacco consumption among women is decreasing at a slower rate than among men. Also, women are more likely to be exposed to other risk factors such as biomass combustion products. Most COPD cases are preventable given the role that smoking and environmental factors play in its development. Knowledge of the causes of COPD in different areas of the globe could provide new insights to address the geographical disparity of the disease and thus make COPD prevention a reality. It is important to implement preventive health policies that might mitigate the expected increase in COPD in women in low-income and middle-income countries and have already proven successful in some regions with high prevalence of the disease. In addition, a reduction in the huge burden of underdiagnosed COPD is necessary to offer effective secondary and tertiary preventive interventions.