COPD: Third Leading Cause of Death Worldwide – Recognize Symptoms and Risks Early

Chronic Obstructive Pulmonary Disease (COPD) remains the third leading cause of death globally, accounting for approximately 3,4 juta fatalities in 2023, according to the World Health Organization (WHO).

• COPD is a progressive condition characterized by persistent airflow obstruction.
• Smoking remains the primary risk factor, affecting approximately 70 juta active smokers in Indonesia.
• Early diagnosis via spirometry is essential for clinical management and maintaining quality of life.

Global Burden of Respiratory Disease

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) projects in its 2026 report that annual deaths from COPD and related conditions will exceed 5,4 juta by 2060. Olenka reported that many of these deaths occur in low- and middle-income countries.

The rise in prevalence is attributed to aging populations and continued tobacco use. In Indonesia, the 2013 Basic Health Research (Riskesdas) data identified a 3.7% prevalence among individuals over age 30, affecting an estimated 9,2 juta people. The Global Adult Tobacco Survey (GATS) 2021 said that approximately 34.5% of Indonesian adults aged 15 and older are active smokers.

Recognizing Early Symptoms

COPD is often diagnosed late because its symptoms appear gradually and worsen over time. Common symptoms include persistent cough, sputum production, and dyspnea, or shortness of breath. Aisyah, a physician, explained that the condition is progressive: early symptoms may only manifest during strenuous activity, but as lung function declines, breathlessness can occur during routine tasks like bathing or dressing.

“Saya sampaikan tadi, kasus PPOK ini adalah kondisi progresif, di mana di awal sesak nafas hanya pada saat aktivitas berat saja. Tapi seiring waktu, kondisi paru menurun, bahkan saat aktivitas sedang atau ringan seperti mandi, mengangkat gayung, ganti pakaian, itu pun bisa menimbulkan sesak nafasnya,” jelas Aisyah.

Tobacco and Environmental Factors Cause Lung Cancer

While smoking is the leading cause, environmental factors also contribute. Pham Cam Phuong, Director of the Center for Nuclear Medicine and Oncology at Bach Mai Hospital, said that tobacco remains the primary cause of lung cancer. Beyond direct tobacco use, passive smoke exposure, occupational dust, chemical fumes, and air pollution contribute to the disease’s pathogenesis.

Even indirect exposure to cigarette smoke increases the risk of lung cancer, and 10% to 20% of lung cancer cases in high-smoking regions occur in non-smokers. According to the implementation guidelines for Article 8 of the WHO Framework Convention on Tobacco Control, only 100% smoke-free environments can effectively protect the public from the harmful effects of secondhand smoke.

Clinical Diagnosis and Standard of Care

Effective management requires confirmation through objective testing. According to the GOLD guidelines, the standard of care for diagnosis involves spirometry—a test that measures the volume and velocity of air expelled from the lungs. Once diagnosed, treatment protocols focus on symptom reduction, preventing exacerbations, and improving quality of life through smoking cessation, avoidance of pollutants, vaccination, and the use of inhalant medications.

Collaborative Efforts in Healthcare

AstraZeneca Indonesia has engaged in cross-sector initiatives to improve respiratory health outcomes. Esra Erkomay, President Director of AstraZeneca Indonesia, stated in a release, “Melihat besarnya beban PPOK secara global dan di Indonesia, upaya mendorong diagnosis sejak dini menjadi semakin penting.” In 2025, the company collaborated with the Indonesian Ministry of Health and the Indonesian Society of Respirology (PDPI) to train over 150 general practitioners on spirometry usage and current management practices.

Future Trajectory of Respiratory Care

The clinical community continues to emphasize that while COPD is progressive, it is manageable with early identification. Patients experiencing chronic respiratory distress are encouraged to seek evaluation from a physician to undergo formal lung function testing.

The focus remains on strengthening primary care capacity to ensure that patients receive timely interventions that preserve functional capacity. “Ke depan, AstraZeneca akan terus mendorong kemajuan ilmu pengetahuan dan inovasi dalam penanganan PPOK, agar semakin banyak pasien dapat mengendalikan gejalanya, meningkatkan kualitas hidup, dan tetap menjalani aktivitas yang bermakna,” said Erkomay.

“Tujuan kita melakukan pengobatan yaitu mengurangi gejala, kemudian mencegah kekambuhan, dan menjaga kualitas hidup,” pungkas Aisyah.

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.