Evolution of endometrial cancer incidence patterns in Hong Kong: A three-decade analysis with future projections.

OBJECTIVE

This study provides a comprehensive analysis of endometrial cancer incidence trends in Hong Kong over the past three decades. It aims to evaluate the impact of demographic shifts and epidemiological factors, including age, birth cohort, and diagnosis period, on the incidence rates. The study also projects future trends in endometrial cancer cases up to 2030 and assesses the contributions of these factors using a detailed decomposition approach.

MATERIAL AND METHODS

The analysis is based on endometrial cancer data obtained from the Hong Kong Cancer Registry. Age-period-cohort (APC) modeling was utilized to investigate the effects of different age groups, historical periods, and birth cohorts on the changing incidence patterns. The study projects future trends using a Bayesian APC framework, integrating historical data and expert insights for robust predictions. Additionally, a decomposition analysis was conducted to disentangle the contributions of demographic changes (aging and population growth) and epidemiological shifts (risk factors such as obesity and reproductive behaviors) to the increasing cases.

RESULTS

Between 1992 and 2021, there were 19,214 recorded cases of endometrial cancer in Hong Kong. Age-standardized and crude incidence rates showed consistent increases, rising from 7.4 per 100,000 person-years in 1992 to 31.0 per 100,000 in 2020. Incidence trends rose significantly across all age groups, with the highest increase seen in women aged 50-65. Projections indicate that the upward trend will continue, with an estimated 1718 cases by 2030. Demographic factors, particularly population aging, and evolving epidemiological trends contribute jointly to the incidence rise.

CONCLUSIONS

The findings reveal a steady increase in endometrial cancer incidence among Hong Kong women, primarily driven by demographic aging and shifts in risk factors. The study underscores the need for targeted public health measures and resource allocation for early detection and effective management strategies, emphasizing the importance of addressing modifiable risk factors such as obesity and reproductive health behaviors.