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This study analyzes COPD and related conditions in Chongqing to understand gender differences and urban-rural diagnostic gaps.

May 27, 2026Open Access

Gender Divergence in COPD Phenotypes and Narrowing Urban–Rural Diagnostic Gaps: A Surveillance Study in Chongqing, China, 2020–2024

Key Points

This study analyzes COPD and related conditions in Chongqing to understand gender differences and urban-rural diagnostic gaps.
Data obtained from Chongqing Chronic Disease Surveillance System (CCDSS) covering 975,421 incident cases and 1,244,978 prevalent cases from 2020 to 2024.
Age-standardized rates calculated using the 2000 Chinese census population.
Analysis of spirometry-confirmed COPD diagnosis rates by urban-rural residence.
Age-standardized prevalence rates for COPD increased from 732.06 to 1,424.54 per 100,000.
Type 1 COPD diagnosis rose from 6.96% in 2022 to 26.04% in 2024, narrowing the urban-rural gap by 0.77 percentage points.
Chronic bronchitis shifted to female predominance after 2023, indicating changing epidemiological trends.

Abstract

Purpose: To analyze epidemiological trends of COPD, chronic bronchitis, and emphysema in Chongqing, China (2020– 2024), and assess spirometry-confirmed diagnosis rates. Patients and Methods: Data were obtained from the Chongqing Chronic Disease Surveillance System (CCDSS), including 975,421 incident cases and 1,244,978 prevalent cases among residents aged ≥ 15 years, and 239,086 deaths from all age groups. Age‑standardized rates were calculated using the 2000 Chinese census population. Type 1 (spirometry‑confirmed) COPD diagnosis rate was analyzed by urban–rural residence. Results: Age-standardized prevalence per 100,000 increased for COPD (732.06 to 1,424.54), emphysema (182.51 to 536.71), and chronic bronchitis (309.48 to 1,021.75). COPD and emphysema were male-predominant; chronic bronchitis became female-predominant after 2023. Rural burden was consistently higher. Type 1 diagnosis rate rose sharply from 6.96% (2022) to 26.04% (2024), with urban-rural gap narrowing to 0.77 percentage points. Conclusion: The rising prevalence mainly reflects improved case ascertainment. Female‑predominant chronic bronchitis highlights the need for sex‑specific public health strategies. The rapid increase in spirometry‑confirmed diagnosis and near‑elimination of urban–rural disparity demonstrate a successful model for diagnostic standardization in primary care. Keywords: chronic obstructive pulmonary disease, epidemiology, surveillance, gender differences, urban-rural disparity, spirometry, Chongqing

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