About one in four adults over 35 could develop chronic obstructive pulmonary disease or COPD, an Ontario study suggests.

COPD is one of the most common lung diseases and causes of death in older people. It leads the airways to slowly close down, making it harder to breathe. The progressive disease is usually caused by emphysema and chronic bronchitis. 

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The COPD rate is evidence to support expanding smoking cessation programs, researchers say. (U.S. Food and Drug Administration/Reuters)

"About one in four individuals are likely to be diagnosed and receive medical attention for COPD during their lifetime," the study's principal investigator, Dr. Andrea Gershon of the Institute for Clinical Evaluative Sciences in Toronto and her co-authors concluded.

The lifetime risk is about triple that of heart attacks, breast cancer in women and prostate cancer in men, and comparable to that of getting asthma, the researchers estimated.

"Our novel findings draw attention to the huge burden of COPD on society and can be used to educate the public about the need for attention and resources to combat the disease. Our results can also be used to justify the continuation and expansion of smoking cessation programs and the development of other strategies to optimize COPD care to improve the lives of affected individuals, their families, and their communities."

In the study that started in 1996, investigators used public health insurance, hospital and other records to follow people aged 35 to 80.

People are considered to be at risk of COPD starting at age 35.

A total of 579,466 new cases were identified during the 14-year study period.

Public overlooks COPD

COPD is the main cause of chronic disease hospitalization in Canada, said Gershon, who is also a respirologist at Sunnybrook Health Sciences Centre.

But the general public seems to know little about it or its importance to public health, perhaps because of its link between COPD and smoking "and the often unspoken belief that COPD patients are the causes of their own misfortune and are undeserving of attention," the study's authors said.

Smoking is the main risk factor for COPD in wealthy countries, but aging, occupational exposures, respiratory infections early in life and a history of asthma are also important, said David Mannino of the University of Kentucky and Fernando Martinez of the University of Michigan Health System in a related journal commentary.

The amount spent on research per case of COPD still lags behind that of other chronic diseases and cancer, the commentators added. They also called for more research investigating the link between asthma and COPD.

The study was funded by the Government of Ontario. The researchers declared no conflicts of interest. The commentators said they have served on advisory boards, received grants or speaking fees from several pharmaceutical companies.