To assess the trends in non-melanoma skin cancer (NMSC) incidence in Hong Kong from 1990 to 2019 and the associations of age, calendar period, and birth cohort, to make projections to 2030, and to ...

Background: This study aims to evaluate the relationship between age, period, and birth cohort with the incidence trends of Nasopharyngeal Carcinoma (NPC) in Hong Kong, make projections through 2030 and parse the drivers of the incidence. Methods: Using data from the Hong Kong Cancer Registry, we used an age-period-cohort model to uniquely estimate age, period, and cohort effects on NPC incidence trends and make projections. We further assessed the drivers of NPC incidence using a validated decomposition algorithm. Results: From 1991 to 2020, crude and age-standardized incidence rates of NPC decreased significantly. The net drifts showed significant downward trends for both sexes, and local drift declined in all age groups. Period and cohort rate ratios revealed monotonic declining patterns for both sexes. Projections suggested that NPC incidence will continue to decline. Population decomposition showed that while population growth and ageing have led to an increase in NPC cases, epidemiologic changes offset these increases, resulting in an encouraging downward trend in the incidence and new NPC cases in Hong Kong. Conclusions: The period and cohort risk of NPC in Hong Kong decreased, and epidemiologic changes offset the contribution of demographic factors, resulting in a continued decline in NPC incidence and cases.

Volatile organic compounds (VOCs) are environmental pollutants that may negatively impact cardiovascular health. This study investigates the association between VOC mixtures, measured through urinary VOC metabolites (VOCMs), and cardiovascular health using Life's Essential 8 (LE8) scores. Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2020 were analyzed for 2967 adults aged 20-79 years. Multiple statistical methods, including correlation analysis, variance inflation factor (VIF) analysis, quantile g-computation (q-gcomp), and Bayesian kernel machine regression (BKMR), were applied to assess the association between VOCMs and LE8 scores. Sensitivity analyses were conducted with different random seeds and subsampling techniques to confirm robustness. Correlation and VIF analyses revealed strong collinearity among VOCMs, highlighting the need for advanced models. Survey-weighted regression indicated that lower VOC exposure was associated with better cardiovascular health. Q-gcomp identified both positive and negative associations between individual VOCMs and LE8 scores, with some unexpected positive associations. BKMR highlighted the complex mixture effects of VOCMs on cardiovascular health. Sensitivity analyses confirmed the consistency of these findings. This study underscores the intricate relationship between VOC exposure and cardiovascular health and the necessity of advanced statistical methods for mixture analysis. Despite some unexpected findings, the results suggest that VOC exposure, as reflected by urinary VOCMs, is associated with adverse cardiovascular health outcomes. Further research is needed to clarify the biological mechanisms and implications of these associations.