Table4_Evolution of Esophageal Cancer Incidence Patterns in Hong Kong, 1992-2021: An Age-Period-Cohort and Decomposition Analysis.pdf

ObjectiveTo elucidate the historical trends, underlying causes and future projections of esophageal cancer incidence in Hong Kong.
MethodsUtilizing the Age-Period-Cohort (APC) model, we analyzed data from the Hong Kong Cancer Registry (1992–2021) and United Nations World Population Prospects 2022 Revision. Age-standardized incidence rates were computed, and APC models evaluated age, period, and cohort effects. Bayesian APC modeling, coupled with decomposition analysis, projected future trends and identified factors influencing incidence.
ResultsBetween 1992 and 2021, both crude and age-standardized incidence rates of esophageal cancer witnessed significant declines. Net drifts exhibited pronounced downward trends for both sexes, with local drift diminishing across all age groups. Period and cohort rate ratios displayed a consistent monotonic decline for both sexes. Projections indicate a continued decline in esophageal cancer incidence. Population decomposition analysis revealed that epidemiological changes offset the increase in esophageal cancer cases due to population growth and aging.
ConclusionThe declining trend of esophageal cancer in Hong Kong is influenced by a combination of age, period, and cohort. Sustaining and enhancing these positive trends requires continuous efforts in public health interventions.

研究目的：阐明香港食管癌发病率的历史变化趋势、潜在成因及未来预测。
研究方法：本研究采用年龄-时期-队列（Age-Period-Cohort, APC）模型，分析香港癌症登记处（Hong Kong Cancer Registry，1992-2021年）及联合国《世界人口展望2022修订版》（United Nations World Population Prospects 2022 Revision）的数据。计算年龄标准化发病率，并通过APC模型评估年龄、时期及队列效应。结合贝叶斯APC建模（Bayesian APC modeling）与分解分析，对未来发病趋势进行预测，并明确影响发病率的相关因素。
研究结果：1992年至2021年间，香港食管癌的粗发病率与年龄标准化发病率均出现显著下降。两性的净漂移均呈现明显的下降趋势，各年龄组的局部漂移均有所缩小。两性的时期与队列率比均呈现持续的单调下降趋势。预测结果显示，食管癌发病率将持续走低。人口分解分析结果表明，流行病学层面的变化抵消了人口增长与人口老龄化所导致的食管癌新增病例数上升。
研究结论：香港食管癌发病率的下降趋势受到年龄、时期及队列三者共同影响。要维持并强化这一良性发展态势，需持续开展公共卫生干预工作。