Bronchiectasis in China: Present Situations and Challenges

Bronchiectasis is a common but long-neglected disease in China, causing great burden both to the patients and to the society. The object of this article is to review and estimate the present status of bronchiectasis in China and the challenges on it, with the aim of bringing more attention to the disease. We review the available studies of bronchiectasis in China – encompassing data on prevalence, causes and related diseases, diagnosis and management – with a focus on the present situation and associated challenges of the disease, and comparing them with those of western countries. The overall prevalence of physician-diagnosed bronchiectasis in people aged ≥40 years was 1.2% and trended upwards with increasing age according to an urban population-based, cross-sectional survey of bronchiectasis in China. The exact etiology cannot be identified in more than 70% of patients in China, with pneumonia and tuberculosis still the most common causes of acquired bronchiectasis. NTM, COPD and asthma were also found and analyzed in bronchiectasis patients. The comprehensive evaluation of the severity of bronchiectasis relies on clinicians' subjective judgments, not according to the multidimensional grading systems such as FACED or BSI. Available treatment statement in China was first established in 2012, through expert consensus on the diagnosis and treatment of adult bronchiectasis, which was mainly in accord with British Thoracic Society (BTS) guideline on bronchiectasis. The majority of clinical work for respiratory physicians in China is treating patients who have severe exacerbations. However, treatment of stable bronchiectasis is ignored and should receive more attention.