Characterization and prediction of non-melanoma skin cancer incidence in China: Joinpoint regression and age-period-cohort model.

Objective: Understanding the non-melanoma skin cancer (NMSC) incidence and its trends in China is an important prerequisite for effective prevention and control of NMSC.

Methods: NMSC incidence data was collected from the Annual Report of China Cancer Registry from 2005 to 2018. The Joinpoint regression model was used to estimate the average annual percent change (AAPC) and annual percent change (APC) to reflect the time trend. Age-period-cohort model with the intrinsic estimator algorithm was used to analyze age, period, and cohort effects. Bayesian age-period-cohort (BAPC) model with integrated nested laplace approximation was used for prediction.

Results: The age-standardized incidence rate (ASIR) of NMSC increased from 1.02/ 100,000 to 1.63/100,000 from 2005 to 2018, showing an increasing trend with AAPC of 3.7% (95% CI: 2.5%, 4.9%). The ASIR was higher in men than in women, while the increase rate was reversed, and it was lower in rural than in urban areas, while AAPC was 1.15 times higher. The risk of NMSC incidence increased with age. The cohort effect was first to increase and then to decrease and the inflection point appeared in 1930-1934. The ASIR of NMSC in China will continue to rise during 2019-2035.

Conclusions: The ASIR of NMSC in China from 2005 to 2018 showed an increasing trend with age, gender, and regional differences, and will continue to increase in the future. NMSC remains a public health problem and requires continuous attention.