Influence of family history and smoking habits on the incidence of self-reported physician's diagnosis of COPD.
BACKGROUND
The incidence of chronic obstructive pulmonary disease (COPD) is little investigated. This study assessed the incidence of a self-reported physician's diagnosis of chronic bronchitis and/or emphysema (CBE) and/or COPD (CBE/COPD), and investigated the effects of a family history of CBE in 1992 and change in smoking habits (assessed in 1992 and 2000) on this incidence.


METHODS
A follow-up study in 2000 of 4933 subjects who responded to a respiratory questionnaire study in 1992 was performed. Response rate was 86.8%. Odds ratios (ORs) for incident cases of CBE/COPD were calculated by multiple Logistic regression.


RESULTS
The cumulative incidence of a physician's diagnosis of CBE/COPD was 2.9%. A family history of CBE predicted incident cases of CBE/COPD, OR 2.7 (95% CI 1.5-5.1). Also continuous smoking, relapse into smoking, or having stopped smoking between 1992 and 2000 had elevated ORs for incident cases of CBE/COPD, 2.6 (1.4-4.7), 7.2 (2.7-18.7), and 2.6 (1.3-5.3), while the OR for ex-smoking in 1992 as well as 2000 was 0.9 (0.4-1.8).


CONCLUSIONS
A family history of CBE increases the risk for development of CBE/COPD. Sustained smoking cessation over many years may be required to significantly reduce the risk of developing CBE/COPD.
Department of Respiratory Medicine and Allergology, Lund University Hospital, SE-221 85 Lund, Sweden. ulf.nihlen@lung.lu.se
Ulf
U
Nihlén
Per
P
Nyberg
Peter
P
Montnémery
Claes-Göran
CG
Löfdahl
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001991:Bronchitis / Q000453:epidemiology; D002908:Chronic Disease; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D011656:Pulmonary Emphysema / Q000453:epidemiology; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology