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1 Center Life Sciences, Beverly Hills, CA, Depts of 2 Community Health Sciences and 3 Epidemiology, UCLA School of Public Health, Los Angeles, CA, 4 Dept of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, OR, 5 Dept of Pulmonary and Critical Care Medicine, University of Kentucky, Lexington, KY, USA.
CORRESPONDENCE: R. J. Halbert, Center Life Sciences, 9100 Wilshire Blvd, Suite 655E, Beverly Hills, CA 90212, USA. Fax: 1 8169361862. E-mail: rhalbert{at}cerner.com
Keywords: Chronic bronchitis, chronic obstructive pulmonary disease, emphysema, meta-analysis, prevalence, spirometry
Received: October 25, 2005
Accepted March 25, 2006
The aim of this study was to quantify the global prevalence of chronic obstructive pulmonary disease (COPD) by means of a systematic review and random effects meta-analysis.
PubMed was searched for population-based prevalence estimates published during the period 1990–2004. Articles were included if they: 1) provided total population or sex-specific estimates for COPD, chronic bronchitis and/or emphysema; and 2) gave method details sufficiently clearly to establish the sampling strategy, approach to diagnosis and diagnostic criteria.
Of 67 accepted articles, 62 unique entries yielded 101 overall prevalence estimates from 28 different counties. The pooled prevalence of COPD was 7.6% from 37 studies, of chronic bronchitis alone (38 studies) was 6.4% and of emphysema alone (eight studies) was 1.8%. The pooled prevalence from 26 spirometric estimates was 8.9%. The most common spirometric definitions used were those of the Global Initiative for Chronic Obstructive Lung Disease (13 estimates). There was significant heterogeneity, which was incompletely explained by subgroup analysis (e.g. age and smoking status).
The prevalence of physiologically defined chronic obstructive pulmonary disease in adults aged
40 yrs is 
9–10%. There are important regional gaps, and methodological differences hinder interpretation of the available data. The efforts of the Global Initiative for Chronic Obstructive Lung Disease and similar groups should help to standardise chronic obstructive pulmonary disease prevalence measurement.
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