Abstract
The increasingly female face of chronic obstructive pulmonary disease (COPD) prevalence among women has equalled that of men since 2008, due in part to increased tobacco use among women worldwide and exposure to biomass fuels. This finding is supported by a number of characteristics. There is evidence of susceptibility to smoking and other airborne contaminants, along with epidemiological and phenotypic manifestations. COPD has thus become the leading cause of death in women in the USA. The clinical presentation is characterised by increasingly pronounced dyspnoea with a marked tendency towards anxiety and depression, undernutrition, nonsmall cell lung cancer (especially adenocarcinoma) and osteoporosis. Quality of life is also more significantly impacted. The theories advanced to explain these differences involve the role played by oestrogens, impaired gas exchange in the lungs and smoking habits. While these differences require appropriate therapeutic responses (smoking cessation, pulmonary rehabilitation, long-term oxygen therapy), barriers to the treatment of women with COPD include greater under-diagnosis than in men, fewer spirometry tests and medical consultations. Faced with this serious public health problem, we need to update and adapt our knowledge to the epidemiological changes.
Abstract
The face of COPD is increasingly female. We need more evidence and a change in how the disease is managed. http://ow.ly/zueL30mWqlS
Footnotes
Provenance: Publication of this peer-reviewed article was sponsored by Novartis, France (article sponsor, European Respiratory Review issue 151).
Conflict of interest: C. Gut-Gobert reports personal fees from Novartis, Chiesi and GSK, outside the submitted work.
Conflict of interest: A. Cavailles has nothing to disclose.
Conflict of interest: A. Dixmier reports non-financial support from Novartis, outside the submitted work.
Conflict of interest: S. Guillot has nothing to disclose.
Conflict of interest: S. Jouneau reports grants and personal fees (fees, funding or reimbursement for national and international conferences, boards, expert or opinion groups and research projects) from Actelion, AIRB, AstraZeneca, BMS, Boehringer, Chiesi, Gilead, GSK, LVL, Mundipharma, Novartis, Pfizer, Roche and Savara-Serendex, outside the submitted work.
Conflict of interest: C. Leroyer has nothing to disclose.
Conflict of interest: S. Marchand-Adam reports personal fees from Novartis, Roche and Boehringer, outside the submitted work.
Conflict of interest: D. Marquette has nothing to disclose.
Conflict of interest: J-C. Meurice reports grants, personal fees and nonfinancial support from ResMed, grants from Philips, personal fees from Fisher Paykel, and personal fees and nonfinancial support from Novartis and Orkyn, outside the submitted work.
Conflict of interest: N. Desvigne reports other fees from Novartis, outside the submitted work.
Conflict of interest: H. Morel has nothing to disclose.
Conflict of interest: C. Person-Tacnet has nothing to disclose.
Conflict of interest: C. Raherison reports personal fees from Novartis, AstraZeneca, Chiesi, GSK and Boeringher Ingelheim, outside the submitted work.
Support statement: The study was supported by Novartis Pharma AG (Paris, France).
- Received June 11, 2018.
- Accepted September 21, 2018.
- Copyright ©ERS 2019.
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