Bronchiectasis is more common in the U.S. than a decade ago, study finds

Five-year prevalence of bronchiectasis in the U.S. reached 221.6 cases per 100,000 people from 2018 to 2022, higher than earlier national estimates, according to a study published online Oct. 30, 2026, in CHEST.

Bronchiectasis is a long-term lung condition that develops when the tubes that carry air in and out of the lungs become damaged, widened and scarred, according to the National Heart, Lung, and Blood Institute. Its exact cause is unknown, but it usually follows an infection or another condition that injures the airway walls or keeps them from clearing mucus. As mucus builds up, bacteria can grow, and each new infection causes more damage.

In children, the condition often occurs alongside cystic fibrosis. In adults, it’s usually seen with severe chronic obstructive pulmonary disease or severe asthma. There is no cure, though most people can keep a good quality of life with care that clears the lungs and lowers the risk of infection.

Kristy Iglay of Merck Research led the study with co-authors who wrote that U.S. data on bronchiectasis are outdated, with the most recent analyses nearly a decade old. Earlier studies also often left out children and people with cystic fibrosis. A current count could raise awareness and support earlier diagnosis and treatment, the authors wrote.

How researchers counted cases

The team used Optum Clinformatics Data Mart, a database of insurance claims from commercial and Medicare Advantage (MA) plans in all 50 states. Out of over 39 million people enrolled for at least one day between January 2018 and December 2022, over 27 million had at least a year of continuous coverage and complete age and sex data. A person counted as a case with at least two outpatient claims for bronchiectasis on separate days or at least one hospital stay with the diagnosis.

Researchers adjusted the results to match the age and sex makeup of the 2022 U.S. population. They also ran two supporting analyses with looser case definitions to test how sturdy the main estimate was.

Rates climbed each year and with age

The main analysis found 94,392 people with bronchiectasis, with a median age of 76. Yearly prevalence rose from 190.6 per 100,000 in 2018 to 234.1 per 100,000 in 2022, an increase of at least 2.3% each year.

Rates were higher in women than in men, at 274.6 vs. 167.8 per 100,000. Folks of Asian background had the highest rate, 302.3 per 100,000. Rates among Black, Hispanic and white people were similar, ranging from 221.9 to 232.1 per 100,000.

MA members had a rate more than 2.5 times that of commercial plan members, 528.6 vs. 199.1 per 100,000. The authors wrote that the gap likely reflects age, since MA members in the study had a median age of 77, compared with 60 for commercially insured members.

Children and cystic fibrosis

Bronchiectasis was rare in children. The study found 465 pediatric cases, for a rate of 11.9 per 100,000 that held steady from year to year. Children ages 12 to 17 had more than double the rate of those younger than 6, at 16.7 vs. 7.5 per 100,000. About 30% of children with bronchiectasis also had cystic fibrosis, compared with 1.4% of all cases.

The supporting analyses suggest the main figures may be low. Counting anyone with a single bronchiectasis code in any setting raised the five-year rate to 411.9 per 100,000 overall and 28.3 per 100,000 in children. A second analysis also counted people with cystic fibrosis who had related conditions or treatments. It more than doubled the rate of cystic fibrosis-related bronchiectasis, from 5.0 to 11.5 per 100,000.

The overall rate is well above the 139 per 100,000 reported in an earlier claims study using data through 2013, though that study included only adults without cystic fibrosis.

“This upward trend may reflect greater disease awareness among clinicians or a genuine increase in [bronchiectasis] occurrence over time,” the authors wrote.

The findings came about a year after the FDA approved Brinsupri (brensocatib) as the first treatment for non-cystic fibrosis bronchiectasis in August 2025.

Where the data fall short

The study’s strengths include its large sample, national reach and closed claims data. It also included children and people with cystic fibrosis. However, cases were identified from billing codes rather than confirmed clinical or imaging findings, so some may be misclassified.

Only 61.5% of children had a prior chest CT scan, compared with 85.0% overall, which the authors said could point to false-positive pediatric cases. The database also leaves out Medicaid and the Children’s Health Insurance Program, which together cover about 1 in 2 U.S. children, according to an estimate the authors cited.

People who switched insurers may have had incomplete records, and the one-year enrollment rule excluded infants younger than 1. The effect of the COVID-19 pandemic is unknown, though a modest slowdown in the rise between 2020 and 2021 may reflect fewer healthcare visits.

The authors wrote that future studies using Medicaid data could give a fuller picture of bronchiectasis prevalence, especially in children. They also called for more research to identify the condition’s underlying causes and to inform treatment and prevention strategies.