Long-term trends and future projections of cancer incidence and mortality in the upper central region of Thailand, 2000-2040.
TL;DR
Despite the declines in infection-related cancers, indicative of effective public health interventions, the overall cancer burden is projected to increase through 2040, mainly driven by increasing incidence and mortality of colorectal and breast cancers.
Abstract
Background
Cancer remains a significant public health concern in Thailand, with substantial regional variation. This study quantified long-term temporal trends and projected future burdens of major cancers in Thailand's upper central region, in the context of evolving public health policies and changing epidemiological patterns.
Methods
Population-based cancer data from 2000 to 2022 were obtained from the Lopburi Cancer Hospital. Temporal trends were analyzed using joinpoint regression and the age-period-cohort model. Future burdens were projected to 2040 using joinpoint regression, the age-period-cohort model, and the NordPred model.
Results
Infection-related cancers declined while lifestyle-associated cancers increased. Age-standardized incidence rates (ASIRs) and mortality rates (ASMRs) for liver and lung cancers declined among men. The colorectal cancer burden among men increased markedly, with ASIRs rising from 8.92 to 24.62 per 100,000 person-years (average annual percent change [AAPC] +4.72%, 95% confidence interval [CI], 3.46-6.47), and ASMRs increasing from 1.83 to 12.15 (AAPC +8.97%, 95% CI, 5.70-12.37). Among women, breast cancer incidence increased from 18.48 to 31.46 (AAPC +2.44%, 95% CI, 0.79-4.73), while mortality increased from 2.10 to 10.00 (AAPC +7.35%, 95% CI, 3.86-11.70). Cervical cancer declined in both incidence and mortality. Colorectal cancer incidence among women increased from 6.51 to 12.06 (AAPC +2.84%, 95% CI, 0.89-6.32), with rising mortality (AAPC +4.03%, 95% CI, 2.76-5.95).
Conclusions
Despite the declines in infection-related cancers, indicative of effective public health interventions, the overall cancer burden is projected to increase through 2040, mainly driven by increasing incidence and mortality of colorectal and breast cancers. This highlights the priority need for organized population-based screening programs and targeted interventions addressing modifiable lifestyle and dietary risk factors.