TY - JOUR
T1 - Regional variations in the prevalence and misdiagnosis of air flow obstruction in China
T2 - baseline results from a prospective cohort of the China Kadoorie Biobank (CKB)
AU - Kurmi, Om
AU - Li, Liming
AU - Smith, Margaret
AU - Augustyn, Mareli
AU - Chen, Junshi
AU - Collins, Rory
AU - Guo, Yu
AU - Han, Yabin
AU - Qin, Jingxin
AU - Xu, Guanqun
AU - Wang, Jian
AU - Bian, Zheng
AU - Zhou, Gang
AU - Davis, Kourtney
AU - Peto, Richard
AU - Chen, Zhenming
AU - China Kadoorie Biobank (CKB) collaborative group
AU - Lancaster, Garry
AU - Yang, Xiaoming
AU - Williams, Alex
AU - Smith, Margaret
AU - Yang, Ling
AU - Chang, Yumei
AU - Millwood, Iona
AU - Chen, Yiping
AU - Lewington, Sarah
AU - Sansome, Sam
AU - Walters, Robin
AU - Hou, Can
AU - Tan, Yunlong
AU - Wang, Zheng
AU - Cai, Xin
AU - Zhou, Huiyan
AU - Chen, Xuguan
AU - Pang, Zengchang
AU - Li, Shanpeng
AU - Wang, Shaojie
AU - Lv, Silu
AU - Zhao, Zhonghou
AU - Liu, Shumei
AU - Pang, Zhigang
AU - Yang, Liqiu
N1 - This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
PY - 2014/5/9
Y1 - 2014/5/9
N2 - BACKGROUND: Despite the great burden of chronic respiratory diseases in China, few large multicentre, spirometry-based studies have examined its prevalence, rate of underdiagnosis regionally or the relevance of socioeconomic and lifestyle factors.METHODS: We analysed data from 512 891 adults in the China Kadoorie Biobank, recruited from 10 diverse regions of China during 2004-2008. Air flow obstruction (AFO) was defined by the lower limit of normal criteria based on spirometry-measured lung function. The prevalence of AFO was analysed by region, age, socioeconomic status, body mass index (BMI) and smoking history and compared with the prevalence of self-reported physician-diagnosed chronic bronchitis or emphysema (CB/E) and its symptoms.FINDINGS: The prevalence of AFO was 7.3% in men (range 2.5-18.2%) and 6.4% in women (1.5-18.5%). Higher prevalence of AFO was associated with older age (p<0.0001), lower income (p<0.0001), poor education (p<0.001), living in rural regions (p<0.001), those who started smoking before the age of 20 years (p<0.001) and low BMI (p<0.001). Compared with self-reported diagnosis of CB/E, 88.8% of AFO was underdiagnosed; underdiagnosis proportion was highest in 30-39-year olds (96.7%) compared with the 70+ age group (81.1%), in women (90.7%), in urban areas (89.4%), in people earning 5K-10 K ¥ monthly (90.3%) and in those with middle or high school education (92.6%).INTERPRETATION: In China, the burden of AFO based on spirometry was high and significantly greater than that estimated based on self-reported physician-diagnosed CB/E, especially in rural areas, reflecting major issues with diagnosis of AFO that will impact disease treatment and management.
AB - BACKGROUND: Despite the great burden of chronic respiratory diseases in China, few large multicentre, spirometry-based studies have examined its prevalence, rate of underdiagnosis regionally or the relevance of socioeconomic and lifestyle factors.METHODS: We analysed data from 512 891 adults in the China Kadoorie Biobank, recruited from 10 diverse regions of China during 2004-2008. Air flow obstruction (AFO) was defined by the lower limit of normal criteria based on spirometry-measured lung function. The prevalence of AFO was analysed by region, age, socioeconomic status, body mass index (BMI) and smoking history and compared with the prevalence of self-reported physician-diagnosed chronic bronchitis or emphysema (CB/E) and its symptoms.FINDINGS: The prevalence of AFO was 7.3% in men (range 2.5-18.2%) and 6.4% in women (1.5-18.5%). Higher prevalence of AFO was associated with older age (p<0.0001), lower income (p<0.0001), poor education (p<0.001), living in rural regions (p<0.001), those who started smoking before the age of 20 years (p<0.001) and low BMI (p<0.001). Compared with self-reported diagnosis of CB/E, 88.8% of AFO was underdiagnosed; underdiagnosis proportion was highest in 30-39-year olds (96.7%) compared with the 70+ age group (81.1%), in women (90.7%), in urban areas (89.4%), in people earning 5K-10 K ¥ monthly (90.3%) and in those with middle or high school education (92.6%).INTERPRETATION: In China, the burden of AFO based on spirometry was high and significantly greater than that estimated based on self-reported physician-diagnosed CB/E, especially in rural areas, reflecting major issues with diagnosis of AFO that will impact disease treatment and management.
U2 - 10.1136/bmjresp-2014-000025
DO - 10.1136/bmjresp-2014-000025
M3 - Article
C2 - 25478177
SN - 2052-4439
VL - 1
JO - BMJ Open Respiratory Research
JF - BMJ Open Respiratory Research
IS - 1
M1 - e000025
ER -
