Regional healthcare has a serious problem with the approach to chronic obstructive pulmonary disease (COPD). In addition to the pending issues in prevention – smoking rates in Murcia are among the highest in the country – there is a generalized diagnostic delay. As a result, the Region has the highest COPD mortality rates in all of Spain, with the exception of Ceuta and Melilla.
According to the largest epidemiological study of COPD carried out to date, Episcan II, 9.4% of Murcians over 40 years of age suffer from this disease (10.5% of men and 8.2% of women). It is a prevalence lower than the national average, but with enormous underdiagnosis: 85.5% of those affected are unaware that they suffer from COPD. Only Castilla-La Mancha and Castilla y León present higher percentages. Throughout Spain, underdiagnosis stands at 74.7%. Considering data from the population over 40 years of age, COPD could affect between 40,000 and 70,000 Murcians, depending on the spirometric criteria used to define the disease. Spirometry is the test that allows measuring the patient’s lung function.
Adjusted mortality rate
by age by COPD
For every 100,000 inhabitants
According to sex. 2021
Source: Ministry of Health. Annual report
of the National Health System 2022
Adjusted mortality rate
by age by COPD
For every 100,000 inhabitants
According to sex. 2021
Source: Ministry of Health. Annual report
of the National Health System 2022
Age-adjusted mortality rate from COPD
For every 100,000 inhabitants, according to sex. 2021
Source: Ministry of Health. Annual Report of the National Health System 2022
The Region of Murcia stands out for its late diagnosis and also for being the community with the highest mortality rates from COPD. Only Ceuta and Melilla present worse data. Specifically, in 2021, 28 deaths from COPD per 100,000 inhabitants were recorded in the Region, while the national average was 20.8. In men, the rate reached 52 deaths per 100,000 (37.6 in Spain), while in women it stood at 12.1 (9.6 in Spain).
On World COPD Day, which is commemorated this Wednesday, the Murcia Society of Respiratory Pathology (Somupar) calls for screening tests to be carried out in health centers to try to tackle underdiagnosis. “Spirometry would be indicated for anyone over the age of 35 with an accumulated consumption of at least ten packs of tobacco per year,” emphasizes Olga Meca, pulmonologist at the Santa Lucía Hospital and president of Somupar. This strategy has already been implemented in other neighboring territories, such as the Valencian Community, she emphasizes.
«We must focus on underdiagnosis and prevention -he emphasizes-; “We are facing a preventable cause of death and morbidity.” Behind COPD is, fundamentally, tobacco. 36.6% of the Murcian population between 15 and 64 years old smokes daily, according to the latest Survey on Alcohol and other Drugs (Ages) in Spain, published at the beginning of the year by the Ministry of Health. Only those from Extremadura, Valencia and Castilian-La Mancha are more addicted to tobacco, with 43.3%, 42.3% and 36.8% of daily smokers, respectively. The national average is 33.1%.
biomass burning
But, in addition, pulmonologists warn of another risk factor: exposure to biomass burning. Inhalation of biomass combustion smoke from wood and coal stoves and stoves in poorly ventilated spaces can favor this disease, as well as environmental pollution or genetic factors. “It is something that must be focused on, because it can be behind COPD in non-smoking people,” explains Olga Meca.
To “raise awareness” about the importance of prevention and early detection, Somupar carried out spirometry tests on the general population this Wednesday in the halls of La Arrixaca and Santa Lucía. «COPD is a respiratory disease that is caused by inflammation of the lungs and generally involves obstruction of the airways. Smoking is the main cause and affects 10% of the Spanish population, causing thousands of deaths a year in our country. Furthermore, according to data from the World Health Organization (WHO), it is the third cause of mortality worldwide, with more than three million deaths per year,” Somupar recalled.
Pulmonologists recommend, especially for smokers, to consult a doctor when there is a persistent cough and discharge that does not disappear over the months. This may indicate the presence of chronic bronchitis. Other symptoms are fatigue, shortness of breath (dyspnea), or frequent respiratory infections.
The high prevalence and mortality from COPD in the Region of Murcia also evidences the need to address chronicity care in the health system, with the aim of avoiding hospitalizations and improving the quality of life of patients. The Association in Defense of Public Health (ADSP) demands a regional plan. The Murcian Health Service (SMS) developed a strategy to address chronicity for the period 2013-2015 that has not yet been updated.
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