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ORIGINAL RESEARCH article

Front. Med.

Sec. Pulmonary Medicine

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1674952

Burden of Chronic Obstructive Pulmonary Disease in China from 1990 to 2021: A Population-Based Study

Provisionally accepted
Xuefang  WangXuefang WangJing  LiuJing LiuJuan  LiJuan LiLing  ZhangLing ZhangXiuqin  ZengXiuqin ZengRuiJun  CaiRuiJun Cai*
  • The People’s Hospital of Jiuquan, Jiuquan, China

The final, formatted version of the article will be published soon.

Background: Chronic obstructive pulmonary disease (COPD) is associated with high prevalence, disability, and mortality rates. As one of the most populous countries facing a significant burden of COPD, the extent of this burden in China remains inadequately defined. This study utilizes data from the Global Burden of Disease Study 2021 (GBD 2021) to analyze the current status and trends of COPD burden in China, aiming to provide epidemiological data to support prevention, early intervention, and policy formulation related to COPD. Methods: This study employs the GBD 2021 database and utilizes various statistical methods, including estimated annual percentage change, Joinpoint regression analysis, decomposition analysis, predictive analysis, and risk factor attribution, to conduct a stratified analysis of the burden of COPD in China by sex, age, and time. Results: Between 1990 and 2021, the age-standardized rate (ASR) of COPD in China showed a significant decline, with projections indicating that this trend will continue. However, the rate of decline has slowed in recent years, and the absolute number of COPD patients continues to rise. In 2021, the age-standardized incidence rate (ASIR) was 215.62 per 100,000, the age-standardized prevalence rate (ASPR) was 2,499.35 per 100,000, the age-standardized mortality rate (ASMR) was 73.23 per 100,000, and the age-standardized disability-adjusted life years (ASDR) was 1,227.66 per 100,000. The decline was more pronounced in females than in males, with females experiencing a lower overall burden. For both sexes, the ASR of COPD increased with age; prior to age 60, rates were similar, but after age 60, males exhibited higher ASMR and ASDR than females. Population aging is identified as the primary driver of the 3 / 23 increasing burden of COPD, while epidemiological changes contribute to its reduction. Smoking remains the leading risk factor for mortality, with eight related risk factors identified. Conclusion: While the ASR of COPD in China has significantly improved, the absolute burden continues to escalate, with notable differences by age and sex. Future efforts should focus on enhancing preventive measures for major risk factors and implementing early screening for high-risk populations to promote early diagnosis and treatment strategies, thereby alleviating the disease burden.

Keywords: chronic obstructive pulmonary disease, China, Incidence, Prevalence, Mortality, DALYs

Received: 28 Jul 2025; Accepted: 06 Oct 2025.

Copyright: © 2025 Wang, Liu, Li, Zhang, Zeng and Cai. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: RuiJun Cai, ruijun0311@126.com

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