Who Has COPD?

Confronting COPD in America focused on people aged 45 and older who reported that they had been diagnosed with COPD, emphysema, or chronic bronchitis, or that they had symptoms of chronic bronchitis. Nearly equal proportions of patients with COPD reported diagnoses of COPD (29%), emphysema but not COPD (32%), and chronic bronchitis but not emphysema or COPD (28%). In addition, 11% of the survey sample was made up of people who met a stringent symptomatic definition of chronic bronchitis* but who had never been diagnosed as having COPD, emphysema, or chronic bronchitis (Figure 2). While the actual population prevalence of undiagnosed COPD is much greater than this would suggest, this subsample of symptomatic but undiagnosed patients with COPD provides important insights into the management of undiagnosed COPD.

COPD is frequently thought of as a disease of the elderly. Yet half (50%) of all patients with COPD surveyed were under 65 years old, and nearly a quarter (22%) were under 55 (Figure 3). The average age at diagnosis was 53 years.

The vast majority of people with COPD surveyed (87%) described themselves as white. The proportion of people with COPD who considered themselves African-American (7%), mixed (3%), or other race (3%) was substantially lower than the expected population proportions for those races (Figure 3). This may have been due in part to lower smoking rates among minority groups in the past, a possible underdiagnosis of COPD in these populations, the sample population, or some combination of these factors.

While COPD is often considered a disease that affects mostly male smokers, more women than men (60% versus 40%) qualified for the survey. Nine out of 10 people with a diagnosis of COPD (89%) or emphysema (92%) were current or former smokers. About three out of five people with diagnosed (63%) or symptomatic (68%) chronic bronchitis had a smoking history (Figure 4). Yet nearly one in five (18%) of all of these patients had never smoked.

There appears to be a strong familial association with COPD. It is unclear if this familial association is related to genetic factors, environmental factors, or both. Half of the patients with COPD surveyed (50%) reported that members of their immediate family outside of their household have had COPD, emphysema, or chronic bronchitis. Similar proportions of people diagnosed with emphysema (42%), and people with diagnosed (48%) or symptomatic (42%) chronic bronchitis, had a family history of COPD (Figure 4).

The survey revealed that most physicians believe that cases of COPD have increased. Nearly six out of 10 physicians (59%) said that the prevalence of COPD in America has increased in the last 10 years (Figure 5).

* Respondents in this category had to report that, for at least two years, they have suffered from persistent (at least three months/year) bronchitis or coughing with phlegm/sputum from the chest.