Du Jianqiang, Sun Haifeng, Sun Yuying, Du Jianfei, Cao Wangnan, Sun Shengzhi
The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University Xi'an 710049, Shaanxi, China.
Third Department of Medical Oncology, Shaanxi Provincial Cancer Hospital Affiliated to Medical College of Xi'an Jiaotong University Xi'an 710061, Shaanxi, China.
Am J Cancer Res. 2021 Dec 15;11(12):5902-5916. eCollection 2021.
The burden of lung cancer in Hong Kong continues to rise. We analyzed trends in lung cancer incidence and associations with age, period, and cohort from 1985 to 2019, made projections up to 2030 and examined the drivers of lung cancer incidence. We used age-period-cohort modeling to estimate age, period, and cohort effects on lung cancer incidence rates in Hong Kong between 1985 and 2019. We projected lung cancer incidence in Hong Kong from 2020 to 2030 using Bayesian age-period-cohort analysis with an integrated nested Laplace approximation. We decomposed changes in the number of lung cancer cases into population growth, population aging, and epidemiologic changes. From 1985 to 2019, the number of lung cancer incident cases in Hong Kong continued to rise, yet the age-standardized incidence rates have declined for both sexes while have fluctuated for females over the past two decades. The overall annual percentage change from 1985 to 2019 was -2.29 (95% CI, -2.53 to -2.05) for males and -0.86 (95% CI, -1.06 to -0.65) for females. Age-specific annual percentages for both sexes showed a decreasing trend in all age groups and were more pronounced for females older than 65 years and males younger than 65 years. Period effects for both sexes showed a similar monotonic downward pattern, with the downward trend slowing for females after 2000. The cohort effect declined monotonically for males and started to plateau for females after the 1945 birth cohort. It was projected that the incident cases of lung cancer in Hong Kong would continue to increase, with 4,435 male cases and 3,561 female cases in 2030. Demographic decomposition suggested that population growth and population aging play an important role in the change of lung cancer cases. Much progress has been made in reducing the incidence of lung cancer in Hong Kong, but this has been offset by demographic changes that will continue to increase the incident cases of lung cancer in Hong Kong, especially among females. There is an urgent need for continued public health policies and clinical programs for risk factor control and necessary screening.
香港肺癌负担持续上升。我们分析了1985年至2019年香港肺癌发病率趋势及其与年龄、时期和队列的关联，对2030年前的发病率进行了预测，并研究了肺癌发病率的驱动因素。我们使用年龄-时期-队列模型来估计1985年至2019年香港肺癌发病率的年龄、时期和队列效应。我们采用贝叶斯年龄-时期-队列分析结合积分嵌套拉普拉斯近似法对香港2020年至2030年的肺癌发病率进行预测。我们将肺癌病例数的变化分解为人口增长、人口老龄化和流行病学变化。1985年至2019年，香港肺癌新发病例数持续上升，但两性的年龄标准化发病率均有所下降，而女性在过去二十年中出现波动。1985年至2019年的总体年百分比变化，男性为-2.29（95%CI，-2.53至-2.05），女性为-0.86（95%CI，-1.06至-0.65）。两性的年龄别年百分比在所有年龄组均呈下降趋势，在65岁以上女性和65岁以下男性中更为明显。两性的时期效应呈现类似的单调下降模式，2000年后女性的下降趋势放缓。男性的队列效应单调下降，1945年出生队列之后女性的队列效应开始趋于平稳。预计到2030年，香港肺癌新发病例将继续增加，男性为4435例，女性为3561例。人口统计学分解表明，人口增长和人口老龄化在肺癌病例变化中起重要作用。香港在降低肺癌发病率方面已取得很大进展，但这被人口结构变化所抵消，这些变化将继续增加香港肺癌新发病例，尤其是女性病例。迫切需要持续实施公共卫生政策和临床项目以控制危险因素并进行必要的筛查。
