Trends of chronic obstructive pulmonary disease mortality in Fenxian district of Shanghai, 2011−2021

Objective  To analyze the mortality trend of chronic obstructive pulmonary disease (COPD) in Shanghai from 2011 to 2021 and provide evidence for development of COPD prevention and control policies .

Methods The death cause surveillance data and population infirmation of residents in Fengxian district of Shanghai from 2011 to 2021 were collected to calculate the the crude mortality rate and the age-standardized-mortality rate of COPD. The overall trends of standardized mortality rate of COPD were analyzed by calculated annual percentage change (APC) and average annual percentage change (AAPC) . Age-period-cohort model was used to analyze the risk for COPD death in different age groups, periods and birth cohorts.

Results A total of 4 587 COPD deaths were reported in Fengxian from 2011 to 2021,with a crude mortality rate of 78.27/100 000 and an age standardized mortality rate of 46.87/100 000. The age standardized mortality rate decreased significantly (AAPC= −8.47%, P<0.001).The crude mortality rate and the age standardized mortality rate of COPD were higher in men (99.22/100 000, 65.47/100 000) than in women (57.79/100 000, 32.09/100 000 ) (P<0.001). The risk for COPD death increased with age, and the risk for COPD death increased rapidly in the super-elderly. The risk in whole population showed a decreasing trend in diferent prtiods from 2011 to 2021, and the risk in women decreased more rapidly during 2011−2014 (APC= −0.20%, P<0.05）compared with that during 2014-2021 (APC= −0.10%, P<0.05）. There was a significant decrease in the risk for COPD death among those born from 1921 to 1940 and no significant change in the risk for death was found in those born after 1940. In men, the risk increased significantly in birth cohorts between 1911 and 1913 (β=1.93, P<0.05), and decreased significantly in birth cohort between 1926 and 1943 (β= −0.23, P<0.05).

Conclusion Although the death risk of COPD in Fengxian continued to decline, the decline rate slowed down with birth cohort year. It is necessary to strengthen the early screening, active intervention, health education, classified managementthe in populations at risk to prevent the incidence and development of COPD and improve the life quality of COPD patients.