Wong Irene Oi Ling, Lam Yan Ting, Lam Kwok Fai, Cowling Benjamin John, Leung Gabriel Matthew
School of Public Health, The University of Hong Kong, Hong Kong SAR, China.
Department of Statistics and Actuarial Science, The University of Hong Kong, Hong Kong SAR, China.
Cancers (Basel). 2021 Nov 16;13(22):5727. doi: 10.3390/cancers13225727.
Hong Kong has an ageing Chinese population with high life expectancy and a rising number of cancer cases. While population ageing could lead to higher incidence, we aim to quantify the demographic and epidemiological contributions to this trend by disentangling the effect of these factors.
We analysed secular trends of cancer incidences of all cancer sites combined, including the five top cancers in men and women in Hong Kong in 1983-2017, by disentangling effects of demographics (ageing population and population growth) and cancer risk/rate change using the RiskDiff methodology.
Overall, age-standardised incidences of all cancers combined in women and in men declined over the study period (-5.3% for women, -30.2% for men), but total incident cancer case counts increased dramatically (156.5% for women, 96% for men). This increase was primarily due to ageing and increasing population (95% age, 66.1% growth for women, and 119.4% age, 25.4% growth for men), while disease risk for all cancers combined has a decreasing trend (-4.5% for women and -48.8% for men). For the site-specific risk changes among the most five common cancer types, there were increases in risks of prostate and colorectal cancers in men, and breast, endometrial, and thyroid cancers in women.
Demographic changes and ageing in our Chinese population resulted in a marked increase in the number of cancer diagnoses in Hong Kong in past decades. The surge in incident case counts overall is expected to stress the healthcare system in terms of the increased demand of healthcare professionals. Cancer surveillance should be enhanced in view of the growing demand from older patients and the cancer types with fast-increasing incidence rates in our population.
香港拥有老龄化的华人人口，预期寿命较高，癌症病例数量不断上升。虽然人口老龄化可能导致发病率上升，但我们旨在通过厘清这些因素的影响，量化人口统计学和流行病学对这一趋势的贡献。
我们使用RiskDiff方法，通过厘清人口统计学因素（人口老龄化和人口增长）以及癌症风险/发病率变化的影响，分析了1983 - 2017年香港所有癌症部位合并的癌症发病率的长期趋势，包括男性和女性的五大常见癌症。
总体而言，在研究期间，女性和男性所有癌症合并的年龄标准化发病率均有所下降（女性为-5.3%，男性为-30.2%），但癌症总发病病例数大幅增加（女性为156.5%，男性为96%）。这种增加主要归因于人口老龄化和人口增长（女性年龄因素占95%，增长因素占66.1%；男性年龄因素占119.4%，增长因素占25.4%），而所有癌症合并的疾病风险呈下降趋势（女性为-4.5%，男性为-48.8%）。对于最常见的五种癌症类型的特定部位风险变化，男性前列腺癌和结直肠癌的风险增加，女性乳腺癌、子宫内膜癌和甲状腺癌的风险增加。
过去几十年，香港华人人口的人口结构变化和老龄化导致癌症诊断数量显著增加。总体发病病例数的激增预计将给医疗系统带来压力，因为对医疗专业人员的需求增加。鉴于老年患者的需求不断增长以及我们人群中发病率快速上升的癌症类型，应加强癌症监测。
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