The incidence of non-cystic fibrosis bronchiectasis is increasing in the United Kingdom (U.K.), with the number of cases much higher than previously thought, according to a survey commissioned by the British Lung Foundation’s Respiratory Health of the Nation project.
The data was published in the study, “Epidemiology of bronchiectasis in the UK: Findings from the British lung foundation’s ‘Respiratory health of the nation’ project,” in the journal Respiratory Medicine.
The goal of the nation project is to report on how many people in the U.K. are affected by major lung diseases, and how these diseases vary by age, gender, region, and standard of living. The project will detail statistics for a variety of lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), lung cancer, pulmonary fibrosis, mesothelioma, and non-cystic fibrosis bronchiectasis (NCFBE).
Bronchiectasis often occurs as a result of other medical conditions, such as respiratory tract infections, bronchial obstructions, autoimmune diseases, connective tissue disorders, as well as genetic disorders such as cystic fibrosis.
To get a clearer picture of the prevalence (number of cases) and incidence (number of new cases) of NCFBE, researchers collected information from patient records in The Health Improvement Network database, for the years 2004 to 2013. This database contains information for about 5% of the U.K. population, so the data were scaled up to generate estimates for the total population.
Information on mortality was gathered from the Office for National Statistics for England and Wales, the General Register Office for Scotland, and the Northern Ireland Statistics and Research Agency.
Survey results revealed that an estimated 211,598 people in the U.K. had NCFBE in 2012, and the disease prevalence increased by 20% from 2008 to 2012, which represents an increase of 40,000 cases during this time.
In 2012, 379 out of 100,000 women had the disease, while 281 out of 100,000 men had the condition.
From 2004 to 2012, about 35% more women were diagnosed with NCFBE, and around 60% of those diagnoses were made in people older than 70.
The data also showed an increase in the rate of first diagnosis. In 2004, 20 per 100,000 people were newly diagnosed with the disease, whereas in 2012, the number increased to 33 per 100,000.
Interestingly, compared to other lung diseases, the chance of being diagnosed with NCFBE is lowest in low-income regions, but increases with higher income status.
Regionally, compared to the rest of the U.K., a higher number of people have NCFBE in the West Midlands, while fewer have the disease in the South East of England.
More people died of NCFBE in 2012 (1,567 deaths: 906 females and 661 males) than in 2008, when there were 1,150 deaths.
People 65 and older accounted for 1,444 of the deaths reported in 2012. The remaining deaths were in those from 15 to 64 years old, while no deaths from NCFBE were recorded for those younger than 15.
Higher mortality rates were identified in the North East, North West, East Midlands, West Midlands, and South East of England, and in Northern Ireland compared with the general U.K. population. Lower mortality rates were observed in the East of England, London, the South West, and Scotland.
Between 2001 and 2017, mortality due to NCFBE was “rising with a 3% annual increase,” said the researchers, who noted that “bronchiectasis represents a considerably larger than appreciated, and increasing burden on U.K. health services.”