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A break in the trend: COPD declines in Sweden

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Sweden has seen a sharp decline in the number of people with chronic obstructive pulmonary disease (COPD). Severe cases have reduced by more than half in 15 years, according to a large new study. The primary explanation is that fewer people smoke. COPD is a major global health problem and is estimated to cause approximately 3,000 premature deaths annually in Sweden alone.

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Helena Backman, lead researcher of the study at Umeå University and project manager for the Obstructive Lung Disease in Norrbotten (OLIN) studies with Region Norrbotten.
Photo: Umeå universitet

“It’s fantastic news that we now have evidence that reduced smoking truly pays off for people’s health,” says Helena Backman, a researcher at Umeå University and project manager for the Obstructive Lung Disease in Norrbotten (OLIN) studies with Region Norrbotten, as well as lead researcher of the study.

The pulmonary disease known as a chronic obstructive pulmonary disease (COPD) is one of the most common diseases of our time and can range from mild to fatal. According to estimates from the Swedish Heart-Lung Foundation, approximately 3,000 people die of COPD annually in Sweden. According to the World Health Organization (WHO), COPD is the fifth most common cause of death in Europe. Smoking is the single most important risk factor for COPD.

Smoking prevention is key

The study is a collaboration between Umeå University, the University of Gothenburg, Region Norrbotten and the Västra Götaland region. Lowie Vanfleteren, senior lecturer at the University of Gothenburg and head of Sahlgrenska University Hospital’s COPD center is one of the researchers in Gothenburg to have contributed to the study.

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Lowie Vanfleteren, senior lecturer at the University of Gothenburg and head of Sahlgrenska University Hospital’s COPD centre has contributed to the study.
Photo: Bildbyrån

“It’s an important message that public initiatives to prevent smoking among young people have had such a major impact on public health. Smoking causes many cases of COPD, which is one of the most common causes of death in the world. In other countries, for example in South America, we’re currently seeing increased incidence of COPD, but in Sweden, we’ve broken the trend,” he says.

Follow-up is underway

The study was published in the journal Respiratory Research and the findings show that a total of about 7 percent of participants had COPD. Incidence in Norrbotten had declined by 41 percent compared to a corresponding study carried out in 1994. There are no previous studies for comparison in Västra Götaland. The decline is also notable compared to several previous studies in other European countries.

The study is based on two surveys of a total of 1,839 randomly selected people, aged 21–78, conducted in Norrbotten and Västra Götaland from 2009 to 2012.

“Follow-up on the results is underway, both here in Västra Götaland and in Norrbotten, but studies by researchers have been put on hold due to the pandemic. The study in west Sweden is called the West Sweden Asthma Study, and it’s led by researchers at the Krefting Research Centre at the University of Gothenburg,” says Lowie Vanfleteren.

Sharp decline in severe COPD

The sharpest decline was seen among more severe cases. Researchers saw a decline by more than half, over 50 percent, among people with severe and moderate COPD in 15 years. About 3.5 percent of study participants had severe or moderate COPD, compared to 8 percent in Norrbotten in 1994.

However, many people still live with COPD without even knowing it or without a diagnosis. The study shows that although the share of people to have received a diagnosis has risen with time, there are still many unreported cases. Currently there is no cure for COPD, but treatments allow many patients to live with relatively few issues from the disease.

Title: Decreased COPD prevalence in Sweden after decades of decrease in smoking

TEXT: Ola Nilsson, Umeå University and Elin Lindström, University of Gothenburg