Differences in diagnostic patterns of obstructive airway disease between areas and sex in Sweden and Finland - the Nordic EpiLung study

Abstract

Objective: To investigate the current prevalence of physician-diagnosed obstructive airway diseases by respiratory symptoms and by sex in Sweden and Finland. Method: In 2016, a postal questionnaire was answered by 34,072 randomly selected adults in four study areas: V€ astra G€ otaland and Norrbotten in Sweden, and Sein€ ajoki-Vaasa and Helsinki in Finland. Results: The prevalence of asthma symptoms was higher in Norrbotten (13.2%), Sein€ ajoki-Vaasa (14.8%) and Helsinki (14.4%) than in V€ astra G€ otaland (10.7%), and physician-diagnosed asthma was highest in Norrbotten (13.0%) and least in V€ astra G€ otaland (10.1%). Chronic productive cough was most common in the Finnish areas (7.7-8.2% versus 6.3-6.7%) while the prevalence of physician-diagnosed chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD) varied between 1.7 and 2.7% in the four areas. Among individuals with respiratory symptoms, the prevalence of asthma was most common in Norrbotten, while a diagnosis of COPD or CB was most common in V€ astra G€ otaland and Sein€ ajoki-Vaasa. More women than men with respiratory symptoms reported a diagnosis of asthma in Sweden and Sein€ ajoki-Vaasa but there were no sex differences in Helsinki. In Sweden, more women than men with symptoms of cough or phlegm reported a diagnosis of CB or COPD, while in Finland the opposite was found. Conclusion: The prevalence of respiratory symptoms and corresponding diagnoses varied between and within the countries. The proportion reporting a diagnosis of obstructive airway disease among individuals with respiratory symptoms varied, indicating differences in diagnostic patterns both between areas and by sex.

Trends in hospital admissions for chronic obstructive pulmonary disease over 16 years in Canada

“…Sex and gender differences in COPD diagnosis and treatment in clinical practice may also explain these observations. [28][29][30] The role of extrinsic factors such as changes in population exposure to air pollution or indoor toxic inhalants should also be considered. 31,32…”