How many die from COPD?

COPD is a major leading cause of death in Australia

In 2014, 7,025 people were recorded as having died from COPD (3,911 males and 3,114 females) making it the fifth leading cause of death after coronary heart disease, dementia and Alzheimer disease, cerebrovascular disease, and lung cancer.

However, the attribution of cause of death in the elderly is often difficult, particularly in relation to COPD and asthma [3, 5, 6]. The statistics presented in this section relate to deaths where COPD was listed as the underlying cause of death. Among those aged 55 and over in Australia, only 40% of deaths where COPD was listed on the death certificate had COPD listed as the underlying cause of death [1].

For information on long-term trends, see General Record of Incidence of Mortality (GRIM) books.

Top five causes of death, 2014
Rank Underlying cause of death Number Per cent
1 Coronary heart disease (I20-I25) 20,173 13.1
2 Dementia and Alzheimer disease (F01, F03, G30) 11,965 7.8
3 Cerebrovascular disease (I60-I69) 10,765 7.0
4 Lung cancer (C33, C34) 8,251 5.4
5 COPD (J40-J44) 7,025 4.6

Notes

  1. Leading causes of death are based on underlying causes of death and classified using an AIHW-modified version of Becker et al. 2006. International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) codes are presented in parentheses.
  2. Data are based on year of registration; deaths registered in 2014 are based on the preliminary version of cause of death data and are subject to further revision by the ABS.

Source: AIHW National Mortality Database.

COPD mortality has declined over time

A recent report Mortality from asthma and COPD in Australia [1] presents detailed analysis of COPD mortality. In Australia, the COPD mortality rate among males decreased by two thirds between 1970 and 2010, from 393 to 136 per 100,000 population (Figure 1).

The COPD mortality rate among females increased between 1965 and 1996, from 36 to 103 per 100,000 population. The female COPD mortality rate showed a small decrease between 1996 and 2010, from 103 to 82 per 100,000 population.

Tobacco smoking is the predominant cause of COPD (Fletcher & Peto 1977) and improvements in COPD mortality rates are expected to follow improvements in smoking rates, with a lag period of 20 to 30 years. In Australia, smoking rates among males decreased from 1945 onwards, and for females decreased from 1976 onwards. It is likely that the decrease in COPD mortality rates among females occurred later than for males because the decline in smoking rates for females occurred later.

Figure 1: COPD death rates among people aged 55 years and over, 3-year moving average, and smoking rates, 1945 to 2010

The horizontal line chart shows that between 1970 and 2010, the COPD death rate among males declined by 65%25, from 393 to 136 per 100,000 population. Over the same period, the COPD death rate for females increased until 1996 (to 103 per 100,000 population), then declined from that year until 2010 (to 82 per 100,000 population). It is probable that the later decrease in COPD mortality rates among females was due to their later decline in smoking rates.

Notes

  1. Age standardised to the 2001 Australian Standard Population.
  2. COPD deaths are restricted to ages 55 and over.
  3. COPD deaths are shown with a 3-year moving average.
  4. Changes to the International Classification of Diseases (ICD) occurred in 1967, 1978 and 1997.
  5. COPD classified according to ICD-7 codes 501, 502, 526, 527.1, ICD-8 codes 518, 490, 491, 492, 519.8, ICD-9 codes 490, 491, 492, 494, 496 and ICD-10 codes J40–J44, J47. In addition to COPD these codes include a condition called bronchiectasis which can be difficult to distinguish from COPD.
  6. See AIHW 2014, Appendix for further details of the death rates.
  7. Smoking data were calculated by the Cancer Council of Victoria. See Scollo and Winstanley 2012 for methodological details.

Sources: [1, 4] (Data table).

Higher death rate from COPD in certain population groups

COPD mortality rates are higher for people living in remote areas and for people living in lower socioeconomic areas [1]. COPD mortality rates are also higher among Indigenous Australians compared with non-Indigenous Australians after adjusting for differences in age-structure. During the period from 2010 to 2014, among those aged 45 and over, the mortality rate for COPD among Indigenous Australians was 176 per 100,000 population, which was 2.8 times that of non-Indigenous Australians (100 per 100,000 population), based on the five jurisdictions with adequate Indigenous identification (NSW, Qld, NT, WA and SA).

The differences between these population subgroups may be due to differences in smoking rates, access to preventative health services, or other factors. Smoking rates are higher among people living in more remote areas, among people living in areas of lower socioeconomic status, and among Indigenous Australians [2].

For more information about COPD mortality rates among Indigenous Australians, see Coronary heart disease and chronic obstructive pulmonary disease in Indigenous Australians.

References

  1. Australian Institute of Health and Welfare (AIHW): Poulos LM, Cooper SJ, Ampon R, Redell HK and Marks GB 2014. Mortality from asthma and COPD in Australia. Cat. no. ACM 30. Canberra: AIHW.
  2. AIHW 2016. Australia's health 2016. Australia's health series no. 15. Cat. no. AUS 199. Canberra: AIHW.
  3. Jones K, Berrill WT, Bromly CL & Hendrick DJ 1999. A confidential enquiry into certified asthma deaths in the north of England, 1994–96: influence of co-morbidity and diagnostic inaccuracy. Respiratory Medicine 93:923–7.
  4. Scollo, MM and Winstanley, MH 2012. Tobacco in Australia: Facts and issues: Prevalence of smoking—adults. 4th edn. Melbourne: Cancer Council Victoria.
  5. Sears MR, Rea HH, De Boer G, Beaglehole R, Gillies AJD, Holst PE et al. 1986. Accuracy of certification of deaths due to asthma. American Journal of Epidemiology 124:1004–11.
  6. Smyth ET, Wright SC, Evans AE, Sinnamon DG & MacMahon J 1996. Death from airways obstruction: accuracy of certification in Northern Ireland. Thorax 51:293–7.