One of the largest causes of death and disability worldwide

Aug 15 2004

A new series of 5 seminars about one of the largest causes of death and disability worldwide - COPD (chronic obstructive pulmonary disease) - starts in this week’s issue of the Lancet.

COPD is a major global health problem that has an increasing disease burden and effect on health-care spending. COPD has recently been described by the WHO Global Obstructive Lung Disease (GOLD) initiative as a disease “characterised by airflow limitation that is not fully reversible. The airflow limitation in most cases is both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases”. This progressive and relentless loss of lung function is the result of emphysema due to destruction of lung tissue and narrowing of small airways as a result of chronic inflammation. Major risk factors for COPD include smoking and exposure to to environmental hazards such as traffic pollution and wood fires for domestic heating.

The global statistics of COPD are striking and underline how this disease has been neglected: it is estimated to be the third largest cause of death worldwide by 2020, with a probable 6 million deaths in Europe each year; COPD is currently the fourth largest cause of death in developed countries; it currently causes 30,000 deaths each year in the UK alone; and it is the only major cause of death that has increased in the USA over the past 3 decades. The five articles in the series will cover the following topics relating to COPD: the burden of disease and clinical features; pathophysiology; management of stable disease; management of severe disease; and the prospect of new drug therapies.

The series has been co-ordinated by Peter Barnes (National Heart & Lung Institute, Imperial College, London, UK) and Sabine Kleinert (Executive Editor at The Lancet). Professor Barnes comments: “By focusing on the advances in understanding and management of COPD, we hope that this series will increase awareness of this currently neglected disease and lead to improved recognition and management”.