Unlike other high-income group countries, cancer accounts for a higher death rate (35%) in Hong Kong (Yiu, 2019a), and is the number one killer. Even though the number of death caused by cancers has been decreasing from about 130 to less than 100 out of 100,000 in the past decade (Figure 1).
However, if you take a micro-view of the incidence rates and death rates of various type of cancer, then you would find a very different story.
First, globally the top 3 types of cancer incidence are breast cancer (0.21%), prostate cancer (0.13%) and Colon & Rectum Cance (0.12%) Figure 1. They are equivalent to 16.7 million, 9.9 million and 9.35 million people respectively.
The incidence rates of the top 2 types of cancer are sharply increasing in HK too. Figures 2 and 3 show their trends of incidence and death rates. The incidence rate of breast cancer has been increasing from about 35 to about 70 out of 100,000 persons, or a 100% increase. The incidence rate of prostate cancer has been increasing from about 10 to about 30 out of 100,000 persons, or a 200% increase.
Yet, these top 2 incidences are not the top 2 killers. Figure 4 shows the total annual number of deaths from various types of cancer. The top 3 killers are tracheal, bronchus, and lung cancer (1.88 million), colon and rectum cancer (0.896m), and stomach cancer (0.865m). Breast cancer and prostate cancer rank the 5th (0.612m) and the 8th (0.416m).
Similar to the global trend, the age-standardized death rates of many types of cancer in HK are decreasing, but the following are exceptions. Figure 5 shows the death rate of breast cancer 1981–2017. It seems to be constantly at about 10 out of 100,000.
The death rate of prostate cancer is also non-decreasing, but increasing from about 3 to about 6 out of 100,000 in the past 4 decades. (Figure 6)
Figure 7 shows the death rate of colorectal cancer 1981–2017 in HK. Only female patients seem to have a decreasing death rate, but not for male patients. The overall death rate is leveling off at about 15 deaths out of 100,000 persons.
Coincidentally, these 3 types of cancer in HK with a non-decreasing trend are the top 3 cancer-incidences (with the highest number of cancer patients in the world). Would they be related or just a coincidence?
I think one of the plausible explanations is that even though the advancement of treatment has been successfully lengthening the lives of the patients, the death rate cannot be reduced due to the substantial increase in the number of incidences.
More recently, there has been some scientific evidence showing that the major causes of these 3 types of cancer are hormone-related and may be strongly affected by the types of food intake (Yiu, 2019b). The change of diet and the substantial increase in the consumption of hormone-disrupting food (Yiu, 2019c) may be related to the increase in the number of incidents and the high death rates of these types of cancer.
CHP (2019) Age-standardized Death Rates by Leading Causes of Death — 2001–2018, Department of Health, HKSAR Government. https://www.chp.gov.hk/en/statistics/data/10/27/339.html
CSD (2015) Persons with Disabilities and Chronic Diseases in Hong Kong, Feature Article, Monthly Digest of Statistics, Jan 2015, Census and Statistics Department, HKSAR Government. https://www.statistics.gov.hk/pub/B71501FB2015XXXXB0100.pdf
Yiu, C.Y. (2019a) Global Death Rates due to Cancer and Cardiovascular Diseases, Medium, Jul 16. https://medium.com/@edwardyiu/global-death-rates-due-to-cancer-and-cardiovascular-diseases-868cd9d43da3
Yiu, C.Y. (2019b) EDC and the Food-Cancer Nexus, Medium, Jul 17. https://medium.com/@edwardyiu/edc-and-the-food-cancer-nexus-a31967fc7902
Yiu, C.Y. (2019c) Meat Consumption Growth in Hong Kong is Alarming, Medium, May 19. https://medium.com/@edwardyiu/meat-consumption-growth-in-hong-kong-is-alarming-872e46bf40ca