Global, regional and national trends in burden of chronic obstructive pulmonary disease (COPD) from 2000 to 2021 and the prediction for 2030: An analysis of the Global Burden of Disease Study 2021

<b>Background</b> Chronic obstructive pulmonary disease (COPD) has been becoming a great public health concern worldwide. However, few studies employed retrospective and predictive approaches to assess the global burden of COPD. Thus, this study aimed to estimate the global burden of COPD by age, gender and socioeconomic status in the past decades of this century, and then make a prediction to 2030.<b>Methods </b>The data analyzed in this study were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The outcome variables, the disease burden of COPD, referred to absolute numbers of COPD case and age-standardized rates (ASRs) per 100,000 individuals per year. The temporal trends from 2000 to 2021 were examined using Joinpoint models. And, Bayesian age-period-cohort models were introduced to project the burden of COPD to 2030. Finally, a decomposition analysis was conducted to reveal the contributions of aging, population growth and epidemiological changes to trends in COPD burden.<b>Results</b> From 2000 to 2021, absolute numbers of incident cases, prevalent cases, deaths and disability-adjusted life years (DALYs) for COPD continued to increase at the global level. However, ASRs of incidence, prevalence, deaths and DALYs decreased, and, moreover, such a declining trend would continue to 2030. Additionally, in 2021, the ASR of COPD burden was higher in males than females, and the rate increased with age among global population. Interestingly, the disease burden varied significantly across different regions, with a comparatively high burden in low socio-demographic index region. Decomposition analysis revealed that the increasing burden of COPD was primarily driven by rapid aging and population growth.<b>Conclusions</b> The global ASRs of COPD burden would continue to decline, but the crude burden would remain increasing to 2030, which was mainly attributed to population aging and growth. This study has significant public health implications that precision intervention strategies shall be initiated for population-based campaigns against COPD with consideration of residents’ age, gender and area as well as economic development.