Trends and Projections of Stomach Cancer Incidence in Hong Kong: A Population-Based Study

The burden of stomach cancer remains high in Hong Kong. We sought to evaluate the associations of age, period, and birth cohort with the changing trend in the incidence of stomach cancer and to provide projections through 2030. We performed an age-period-cohort analysis and projections up to 2030 using data from the Hong Kong Cancer Registry. Additionally, we used a population decomposition algorithm to assess the drivers in the number of incident cases of stomach cancer in Hong Kong. Among the 26,813 stomach cancer patients, from 1994 to 2018, the age-standardized incidence rate of stomach cancer decreased for both sexes. The incidence increased with age and was highest for those aged 85 years or older. Period relative risk (RR) showed a monotonic decreasing pattern throughout the study period for both sexes before 2010. Cohort RR for males was monotonically decreasing but changed little after the 1967-1971 birth cohort. In contrast, cohort RR for females declined in the pre-1927-1931 birth cohort but slowed down since. It is projected that there will be 906 male patients and 954 female patients in 2030. Decomposition analysis suggested that population growth and aging were associated with substantial changes in the number of incident cases of stomach cancer in Hong Kong. Both period and cohort risk of developing stomach cancer in Hong Kong have slowed down or plateaued. Our study demonstrates that population aging and growth are the main drivers of the increased number of incident cases of stomach cancer in Hong Kong.