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. 2024 Feb 16:45:101030.
doi: 10.1016/j.lanwpc.2024.101030. eCollection 2024 Apr.

The trends in lung cancer prevalence, incidence, and survival in Hong Kong over the past two decades (2002-2021): a population-based study

Philip Cm Au  1 , Anne Wm Lee  2 , Victor Hf Lee  2 , Ian Ck Wong  1   3   4   5 , Rina Ym Hui  6 , Ching-Lung Cheung  1   3
Affiliations

The trends in lung cancer prevalence, incidence, and survival in Hong Kong over the past two decades (2002-2021): a population-based study

Philip Cm Au et al. Lancet Reg Health West Pac. .

Abstract

Background: Over the past decades, significant progress in lung cancer management has been made. However, the trends in prevalence and survival of lung cancer in the Chinese population over the last decade remain unexplored. This study utilised a territory-wide electronic medical database in Hong Kong to provide the most up-to-date and comprehensive analysis of the trends in prevalence, incidence, and survival over the past two decades.

Methods: Descriptive epidemiology study using a retrospective cohort of lung cancer patients from the Clinical Data Analysis and Reporting System (CDARS). 10-year limited-duration prevalence, incidence, and relative period survival were calculated between 2002 and 2021. Sub-groups of age, sex, and comorbidity were examined. The annual percent change (APC) and average annual percent change (AAPC) were estimated using joinpoint regression.

Findings: This study included 87,259 incident cases between 2002 and 2021. The 10-year limited duration prevalence (per 100,000 persons) of lung cancer increased from 153.4 to 228.7 (AAPC: 3.08%). Crude incidence (per 100,000 persons) increased from 55.0 to 70.3 (APC: 1.23%), while age-standardised incidence decreased from 42.9 to 33.2 (APC: -1.32%). The 1-year and 5-year relative period survivals showed an increasing trend but remained low. Disparity in trends was observed among different sex and age groups.

Interpretation: Lung cancer burden has been increasing partly due to population ageing. Although survival showed improvement over the years, it remained low, highlighting the potential need for interventions. Further study exploring the disparity in sex-specific trends is warranted.

Funding: The Innovation and Technology Commission, Hong Kong.

Keywords: Epidemiology; Incidence; Lung cancer; Prevalence; Survival; Trends.

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Conflict of interest statement

PCA, AWL, VHL, ICW, and CLC declare that they have no competing interests. RYH declares that in the past 36 months, all outside of the submitted work, the author received grants from AstraZeneca, Bristol Myers Squibb, Corvus, Eisai, Eli Lilly, Janssen, Merck Sharp & Dohme, Novartis, and Roche; consulting fees from Amgen, AstraZeneca, Bristol Myers Squibb, Eisai, Eli Lilly, Janssen, Merck Sereno, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Takeda, and Zai Lab; honoraria from AstraZeneca, Eli Lilly, Janssen, Merck Sharp & Dohme, and Novartis. The study sponsor, ITC, did not interfere with authors’ access to study’s data, or that interfere with their ability to analyse and interpret the data and to prepare and publish manuscripts independently.

Figures

Fig. 1
Fig. 1
The trends in lung cancer 10-year limited-duration prevalence between 2008 and 2021. (A) Whole population; (B) by sex; (C) by age group. AAPC: average annual percent change, APC: annual percent change. ∗Indicates significant (p ≥ 0.05) APC/AAPC.
Fig. 2
Fig. 2
The trends in lung cancer incidence between 2002 and 2021. (A) Whole population; (B) by sex, age-standardised; (C) by age group. AAPC: average annual percent change, APC: annual percent change. ∗Indicates significant (p ≥ 0.05) APC/AAPC.
Fig. 3
Fig. 3
The trends in lung cancer 1-year/5-year relative period survival between 2004 and 2021. (A) 1-year relative period survival by sex, (B) 5-year relative period survival by sex; (C) 1-year relative period survival by age group, (D) 5-year relative period survival by age group; (E) 1-year relative period survival by comorbidity severity, (F) 5-year relative period survival by comorbidity severity. AAPC: average annual percent change, APC: annual percent change, CCI: Charlson Comorbidity Index. ∗Indicates significant (p ≥ 0.05) APC/AAPC.
Fig. 4
Fig. 4
Comparison with the sex-specific age-standardised incidence reported by the Hong Kong Cancer Registry.
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