Abstract：Objective To investigate the trends of chronic obstructive pulmonary disease (COPD) incidence and mortality in China from 1992 to 2021 with age, period and birth cohort, so as to provide insights into the prevention and control of COPD. Methods The crude incidence rates, crude mortality rates, standardized incidence rates and standardized mortality rates of COPD in China from 1992 to 2021 were collected through the Global Burden of Disease Study 2021 database. The impacts of age, period and cohort on the incidence and mortality of COPD were analyzed using an age-period-cohort model. Results The standardized incidence rates of COPD in China ranged from 271.24/105 in 1992 to 215.62/105 in 2021, and the standardized mortality rates ranged from 226.08/105 in 1992 to 73.23/105 in 2021, both showing downward trends. Age-period-cohort analysis showed that the incidence and mortality rates of COPD increased with age. The incidence rates rose more rapidly after the age of 35 years, from 138.45/105 in the age group of 35-<40 years to 2 538.61/105 in the age group of 85-<90 years. The mortality rates rose more rapidly after the age of 60 years, from 73.73/105 in the age group of 60-<65 years to 1 053.88/105 in the age group of 85-<90 years. The incidence and mortality risks of COPD declined with time. Compared with the period of 2002-2006, the incidence (RR=0.866, 95%CI: 0.845-0.888) and mortality risks (RR=0.418, 95%CI: 0.394-0.445) of COPD were the lowest in 2017-2021. The incidence and mortality risks of COPD declined with the year of birth. Compared with the 1950-1954 birth cohort, the incidence (RR=0.530, 95%CI: 0.404-0.694) and mortality risks (RR=0.042, 95%CI: 0.007-0.276) of COPD were the lowest in the 2002-2006 birth cohort. Conclusion The incidence and mortality rates of COPD in China from 1992 to 2021 increased with age, but decreased with time and the year of birth.
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