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                  <mods:namePart>Soriano, Joan B</mods:namePart>
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                  <mods:namePart>Ancochea, Julio</mods:namePart>
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               <mods:identifier type="citation">Arch Bronconeumol. 2023 Mar;59(3):142-151.</mods:identifier>
               <mods:identifier type="journal">Archivos de Bronconeumología</mods:identifier>
               <mods:identifier type="pubmedID">36549937</mods:identifier>
               <mods:identifier type="uri">https://hdl.handle.net/20.500.12105/26099</mods:identifier>
               <mods:abstract>Introduction: We aim to describe the changes in prevalence and risk factors associated to chronic obstructive pulmonary disease (COPD) in Spain, comparing three population-based studies conducted in three timepoints.

Methods: We compared participants from IBERPOC conducted in 1997, EPISCAN conducted in 2007 and EPISCAN II in 2017. COPD was defined as a postbronchodilator FEV1/FVC (forced expiratory volume in 1s/forced vital capacity) ratio &lt;0.70, according to GOLD criteria; subsequently, also as the FEV1/FVC below the lower limit of normal (LLN).

Results: COPD prevalence in the population between 40 and 69 years decreased from 21.6% (95% CI 20.7%-23.2%) in 1997 to 8.8% (95% CI 8.2%-9.5%) in 2017, a 59.2% decline (p&lt;0.001). In 2007, the prevalence was 7.7% (95% CI 6.8%-8.7%) with an upward trend of 1.1 percentage points in 2017 (p=0.073). Overall COPD prevalence decreased in men and women, although a significant increase was observed in the last decade in females (p&lt;0.05). Current smokers significantly increased in the last decades (25.4% in 1997, 29.1% in 2007 and 23.4% in 2017; p&lt;0.001). Regrettably, COPD underdiagnosis was constantly high, 77.6% in 1997, 78.4% in 2007, and to 78.2% in 2017 (p=0.95), higher in younger ages (40-49 yrs and 50-59 yrs) and also higher in women than in men in all three studies (p&lt;0.05).

Conclusions: We report a significant reduction of 59.2% in the prevalence of COPD in Spain from 1997 to 2017 in subjects aged 40-69 years. Our study highlights the significant underdiagnosis of COPD, particularly sustained in women and younger populations.</mods:abstract>
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                  <mods:topic>COPD</mods:topic>
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                  <mods:topic>Prevalence</mods:topic>
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               <mods:subject>
                  <mods:topic>Smoking</mods:topic>
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                  <mods:topic>Spain</mods:topic>
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               <mods:subject>
                  <mods:topic>Spirometry</mods:topic>
               </mods:subject>
               <mods:subject>
                  <mods:topic>Underdiagnosis</mods:topic>
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                  <mods:title>Trends of COPD in Spain: Changes Between Cross Sectional Surveys 1997, 2007 and 2017.</mods:title>
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