Background We performed an analysis of UK respiratory disease epidemiology covering 2004–2012. Findings pertaining to COPD are presented here.

Methods Prevalence and incidence rates were estimated from The Health Intelligence Network database representing ∼5 per cent of the population. Mortality figures came from official government statistics. WHO data were used for international mortality comparisons and numbers of hospital admissions/inpatient bed-days.

Results An estimated 1.2 million people (2% of the population) have diagnosed COPD – considerably more than the 835,000 estimated by the Department of Health in 2011 – making COPD the second most common lung disease in the UK, after asthma. Prevalence has increased by 27% in the last decade. Incidence fell 2004–2008 but has been stable since with just under 115,000 new diagnoses in 2012. Men are more likely to be diagnosed with COPD and to die from it than women. COPD is rare under 40 and becomes commoner with age, affecting 9% of those aged >70. COPD prevalence, incidence and mortality rates are highest in Scotland and the north of England. Prevalence and incidence are over twice as great in the most deprived population quintile than in the least. Nearly 30,000 people die from COPD each year, making it the second greatest cause of death from lung disease and the UK’s fifth biggest killer. Mortality increased from 2004–2012. The UK COPD mortality rate ranks third in Europe. COPD accounts for over 140,000 hospital admissions and over a million bed days each year across the UK (1.7% of all hospital admissions and bed days). 97% of these admissions are for emergency care. London has notably more hospital admissions for COPD than other regions with similar prevalence.

Conclusions Gender, location, and deprivation differences in COPD epidemiology probably largely reflect differences in smoking behaviour. COPD continues to represent an enormous burden on UK health services.