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Background <p>Colorectal cancer (CRC) remains a major public health burden in Hong Kong. Although screening programs and lifestyle changes have contributed to recent declines in age-standardized rates, the absolute burden continues to rise due to rapid population aging. A comprehensive understanding of long-term trends and their demographic drivers is essential for future cancer control planning. This study aimed to comprehensively assess long-term CRC incidence trends in Hong Kong and to project the future disease burden.</p> Methods <p>We analyzed CRC incidence data from the Hong Kong Cancer Registry (1983–2022). Crude and age-standardized incidence rates were calculated by sex and age group. Temporal patterns were assessed using age–period–cohort models, future incidence was projected using Bayesian APC methods, and decomposition and scenario analyses were conducted to evaluate demographic drivers and potential screening impacts.</p> Results <p>From 1983 to 2022, a total of 141,566 CRC cases were registered in Hong Kong. Age-standardized incidence rates stabilized and declined after 2010, whereas crude rates and absolute case numbers continued to increase, driven mainly by population aging. Bayesian projections indicated further declines in incidence rates through 2032, but the absolute burden is expected to remain substantial, with total annual cases exceeding 12,000. Decomposition analysis identified population aging as the dominant contributor to long-term increases in case numbers, and screening scenario analyses suggested that higher uptake could potentially accelerate declines in age-standardized incidence rates under simplified assumptions.</p> Conclusions <p>Although age-standardized CRC incidence rates are declining in Hong Kong, the absolute burden is expected to remain high due to population aging. These findings highlight the combined importance of addressing demographic aging and expanding organized screening to reduce future CRC burden.</p>

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Unraveling colorectal cancer incidence dynamics in Hong Kong 1983–2032 through age–period–cohort Bayesian projection and decomposition analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月21日

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  • Linlin Wei,
  • Sixian Li,
  • Mengyun Liang,
  • Zhihong Han,
  • Haifeng Sun,
  • Jianqiang Du

摘要

Background

Colorectal cancer (CRC) remains a major public health burden in Hong Kong. Although screening programs and lifestyle changes have contributed to recent declines in age-standardized rates, the absolute burden continues to rise due to rapid population aging. A comprehensive understanding of long-term trends and their demographic drivers is essential for future cancer control planning. This study aimed to comprehensively assess long-term CRC incidence trends in Hong Kong and to project the future disease burden.

Methods

We analyzed CRC incidence data from the Hong Kong Cancer Registry (1983–2022). Crude and age-standardized incidence rates were calculated by sex and age group. Temporal patterns were assessed using age–period–cohort models, future incidence was projected using Bayesian APC methods, and decomposition and scenario analyses were conducted to evaluate demographic drivers and potential screening impacts.

Results

From 1983 to 2022, a total of 141,566 CRC cases were registered in Hong Kong. Age-standardized incidence rates stabilized and declined after 2010, whereas crude rates and absolute case numbers continued to increase, driven mainly by population aging. Bayesian projections indicated further declines in incidence rates through 2032, but the absolute burden is expected to remain substantial, with total annual cases exceeding 12,000. Decomposition analysis identified population aging as the dominant contributor to long-term increases in case numbers, and screening scenario analyses suggested that higher uptake could potentially accelerate declines in age-standardized incidence rates under simplified assumptions.

Conclusions

Although age-standardized CRC incidence rates are declining in Hong Kong, the absolute burden is expected to remain high due to population aging. These findings highlight the combined importance of addressing demographic aging and expanding organized screening to reduce future CRC burden.