Lifetime risk of hospital diagnosed chronic obstructive pulmonary disease in remote Aboriginal people: a cohort study

Objective: To estimate the lifetime risk of developing hospital-diagnosed chronic obstructive pulmonary disease (COPD) in Aboriginal people living in remote areas. Methods: A total of 1,374 participants in a remote community were followed up to 20 years. Individuals with hospital-diagnosed COPD were identified through hospital records. The lifetime risk of hospital-diagnosed COPD was estimated using a modified technique of survival analysis. Results: Of the 1,374 participants, 164 were identified as having incident hospital-diagnosed COPD during 21,614 person years of follow-up. After adjusting for the presence of competing risk of death from non-COPD causes, the lifetime risk of COPD was 53% for the overall population, higher in women (61%) than in men (45%). Adjusting for baseline age and smoking status, women had a significantly higher risk of COPD than men with a hazard ratio (HR) = 1.55 (95%CI 1.13-2.14), while men were more likely to die from non-COPD causes than women before being diagnosed as having COPD, HR = 2.30 (95%CI 1.64-3.23). Conclusions: These Aboriginal people have a high lifetime risk of COPD, and one in two have hospital-diagnosed COPD during their lifetime. Our findings warrant further efforts and resources to combat this condition in remote Aboriginal communities