Ethnicity-associated disparities in prevalence of chronic obstructive pulmonary disease: a population-based cross-sectional study in Yunnan Province, China

To provide a preliminary exploration of ethnic-specific chronic obstructive pulmonary disease (COPD) risk and prevalence among adults in Yunnan Province, thereby offering foundational insights to inform targeted prevention strategies. This study is based on a large-scale epidemiological survey of COPD in Yunnan Province, which recruited 11,095 adults aged 20 years and older from 16 counties using a multi-stage, randomized cluster sampling strategy. Participants were initially screened using COPD-SQ and COPD-PS. High-risk individuals were defined as those with a COPD-SQ score ≥ 16 and/or a COPD-PS score ≥ 5. Spirometry was performed only on high-risk individuals. By analyzing data from standardized questionnaires, physical examinations, and pulmonary function tests, we compared the characteristics of high-risk populations and confirmed COPD patients across different ethnic groups. After ethnic-specific selection, 9,419 participants (Han: 7,839; Tibetan: 567; Dai: 575; Hui: 207; Lahu: 231) were included. High-risk COPD rates were 22.2% (Han), 16.0% (Tibetan), 12.7% (Dai), 35.3% (Hui) and 15.6% (Lahu). The overall COPD prevalence estimates (calculated as spirometry-confirmed cases divided by the screened population), were 6.2%, 3.5%, 1.9%, 10.1%, and 3.0%, respectively. Ethnicity remained an independent determinant of both high risk and disease (P < 0.001). Biomass-related COPD showed a relatively high prevalence in Hui (16.1%). Preliminary findings from this exploratory analysis suggest potential ethnic differences in COPD high-risk rate and prevalence among the studied groups in Yunnan Province, with relatively higher estimates observed in the Hui group and relatively lower estimates in the Dai group. Demographic and clinical profiles further differed across groups, underscoring the need for ethnicity-specific interventions.