Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review

Background: A recent systematic review showed Japan’s mortality from chronic obstructive pulmonary disease (COPD) is the lowest among 204 countries, despite notably higher smoking rates in men in Japan than in the United States. This study aims to compare (1) trends in smoking rates, (2) trends in C...

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Main Authors: Akira Sekikawa, Mengyi Li, Niva Joshi, Brandon Herbert, Curtis Tilves, Chendi Cui, Shiyao Gao, Yuefang Chang, Yasutaka Nakano, Frank C Sciurba
Format: Article
Language:English
Published: Japan Epidemiological Association 2025-02-01
Series:Journal of Epidemiology
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Online Access:https://www.jstage.jst.go.jp/article/jea/35/2/35_JE20240085/_pdf
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author Akira Sekikawa
Mengyi Li
Niva Joshi
Brandon Herbert
Curtis Tilves
Chendi Cui
Shiyao Gao
Yuefang Chang
Yasutaka Nakano
Frank C Sciurba
author_facet Akira Sekikawa
Mengyi Li
Niva Joshi
Brandon Herbert
Curtis Tilves
Chendi Cui
Shiyao Gao
Yuefang Chang
Yasutaka Nakano
Frank C Sciurba
author_sort Akira Sekikawa
collection DOAJ
description Background: A recent systematic review showed Japan’s mortality from chronic obstructive pulmonary disease (COPD) is the lowest among 204 countries, despite notably higher smoking rates in men in Japan than in the United States. This study aims to compare (1) trends in smoking rates, (2) trends in COPD mortality, and (3) the spirometry-based COPD prevalence in the general adult population between Japan and the United States. Methods: Age- and sex-specific smoking rates from the 1980s through 2010s and COPD mortality from 1999 through 2019 were obtained from national surveys and official statistics (International Classification of Diseases-10th codes J40–44), respectively. A systematic review and meta-analysis was performed to estimate COPD prevalence in Japan, while the National Health and Nutrition Examination Survey 2007–2012 was used for the United States. A fixed ratio of 0.7 of forced expiratory volume in the first second of forced vital capacity was used to define COPD. Results: Over the past 4 decades, men in Japan consistently had 20–30% higher smoking rates than their United States counterparts. From 1999–2019, age-adjusted COPD mortality in men in Japan was only a third of the United States, whereas that in women was less than a tenth in 2019. Synthesizing data from 11 studies, involving 89,955 participants, Japan’s COPD prevalence was more than 10% lower than in the United States in almost all age groups for both sexes. Conclusion: This study showed markedly lower rates of COPD in Japan than in the United States. Investigating factors contributing to the paradoxical observations could lead to advancing COPD risk reduction strategies.
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spelling doaj-art-c337a59e9d774c5ba3c5c321d53bb40e2025-02-05T04:49:20ZengJapan Epidemiological AssociationJournal of Epidemiology0917-50401349-90922025-02-01352909910.2188/jea.JE20240085Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic ReviewAkira Sekikawa0Mengyi Li1Niva Joshi2Brandon Herbert3Curtis Tilves4Chendi Cui5Shiyao Gao6Yuefang Chang7Yasutaka Nakano8Frank C Sciurba9Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USADepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USADepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USADepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USADepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USADepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USADepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USASchool of Medicine, University of Pittsburgh, Pittsburgh, PA, USADivision of Respiratory Medicine, Department of Internal Medicine, Shiga University of Medical Science, Shiga, JapanSchool of Medicine, University of Pittsburgh, Pittsburgh, PA, USABackground: A recent systematic review showed Japan’s mortality from chronic obstructive pulmonary disease (COPD) is the lowest among 204 countries, despite notably higher smoking rates in men in Japan than in the United States. This study aims to compare (1) trends in smoking rates, (2) trends in COPD mortality, and (3) the spirometry-based COPD prevalence in the general adult population between Japan and the United States. Methods: Age- and sex-specific smoking rates from the 1980s through 2010s and COPD mortality from 1999 through 2019 were obtained from national surveys and official statistics (International Classification of Diseases-10th codes J40–44), respectively. A systematic review and meta-analysis was performed to estimate COPD prevalence in Japan, while the National Health and Nutrition Examination Survey 2007–2012 was used for the United States. A fixed ratio of 0.7 of forced expiratory volume in the first second of forced vital capacity was used to define COPD. Results: Over the past 4 decades, men in Japan consistently had 20–30% higher smoking rates than their United States counterparts. From 1999–2019, age-adjusted COPD mortality in men in Japan was only a third of the United States, whereas that in women was less than a tenth in 2019. Synthesizing data from 11 studies, involving 89,955 participants, Japan’s COPD prevalence was more than 10% lower than in the United States in almost all age groups for both sexes. Conclusion: This study showed markedly lower rates of COPD in Japan than in the United States. Investigating factors contributing to the paradoxical observations could lead to advancing COPD risk reduction strategies.https://www.jstage.jst.go.jp/article/jea/35/2/35_JE20240085/_pdfcopdepidemiologyjapan, and the usmortalityprevalencesmoking
spellingShingle Akira Sekikawa
Mengyi Li
Niva Joshi
Brandon Herbert
Curtis Tilves
Chendi Cui
Shiyao Gao
Yuefang Chang
Yasutaka Nakano
Frank C Sciurba
Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review
Journal of Epidemiology
copd
epidemiology
japan, and the us
mortality
prevalence
smoking
title Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review
title_full Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review
title_fullStr Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review
title_full_unstemmed Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review
title_short Much Lower Prevalence and Mortality of Chronic Obstructive Pulmonary Disease in Japan Than in the United States Despite Higher Smoking Rates: A Meta-Analysis/Systematic Review
title_sort much lower prevalence and mortality of chronic obstructive pulmonary disease in japan than in the united states despite higher smoking rates a meta analysis systematic review
topic copd
epidemiology
japan, and the us
mortality
prevalence
smoking
url https://www.jstage.jst.go.jp/article/jea/35/2/35_JE20240085/_pdf
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