A subnational analysis for mortality and prevalence of chronic obstructive pulmonary disease in China 1990- 2013: Findings from Global Burden of Disease Study (GBD) 2013.

Abstract The trends of COPD mortality and prevalence over the past two decades across all provinces remain unknown in China. We used data from the Global Burden of Disease Study 2013 (GBD 2013) to estimate the mortality and prevalence of COPD during 1990-2013 at provincial level. Following the general analytical strategy used in GBD 2013, we analyzed the age-sex-province-specific mortality and prevalence for COPD in China. Levels of and trends in COPD mortality and prevalence were assessed for 33 province-level administrative units during 1990-2013. In 2013, there were 910 809 COPD deaths in China, accounting for 31.1% of total COPD deaths in the world. From 1990 to 2013, the age-standardized COPD mortality rate decreased in all provinces, with the highest reduction in Heilongjiang (70.2%) and Jilin (70.0%) and lowest reduction in Guizhou (26.8%). In 2013, the death rate per 100,000 was highest in Guizhou (196.0) and lowest in Tianjin (34.0) among men and highest in Gansu (141.1) and lowest in Beijing (23.7) among women. The number of COPD cases increased dramatically from 32.4 million in 1990 to 54.8 million in 2013. The age-standardized prevalence rate of COPD remains stable overall and varied little for all provinces. COPD remains a huge health burden in many western provinces in China. The substantial increase of COPD cases represents an ongoing challenge given the rapidly ageing Chinese population. Targeted control and prevention strategy should be developed at provincial level to reduce the burden caused by COPD.