Abstract

Background/Objectives: Korea has undergone rapid epidemiological transitions in cancer incidence over the past two decades. Using a 25-year nationwide dataset (1999–2023), we characterize long-term trends for 61 cancer types, examine inter-cancer correlations, and forecast incidence to 2028. Methods: Annual incidence counts, crude rates, and age-standardized incidence rates (ASIRs) stratified by sex were obtained from the Korea Central Cancer Registry (KCCR) via the Korean Statistical Information Service (KOSIS). Annual percent change (APC) was estimated using log-linear regression. Pearson correlation coefficients were computed among cancer-specific ASIRs, with false-discovery-rate (FDR) correction for multiple comparisons. Multiple and hierarchical regression evaluated the statistical association of individual cancer types with the overall cancer rate, and variance inflation factors (VIFs) were used to quantify multicollinearity. Time series forecasting used damped Holt–Winters exponential smoothing; forecast accuracy was assessed with rolling-origin cross-validation (RMSE, MAE, MAPE) and benchmarked against ARIMA. A sensitivity analysis excluding the pandemic years (2020–2021) tested the robustness of trend estimates. Five-year prevalence data (2007–2023) were analyzed from the KCCR prevalence module. Results: Total cancer incidence increased from 101,854 in 1999 to 288,613 in 2023, a 183% increase. The overall ASIR rose from 402.7 to 522.9 per 100,000 (2020 standard population). The three fastest-growing cancers were thyroid (APC +7.56%, p < 0.001), prostate (+6.98%, p < 0.001), and breast (+5.03%, p < 0.001). Stomach (APC −2.20%) and liver (−2.90%) cancers showed significant declines. Hierarchical regression showed that adding thyroid, breast, and prostate to lung and stomach increased explained variance from R2 = 0.449 to 0.997; however, high VIF values (up to ~263) indicate substantial multicollinearity and compositional dependence, so these coefficients should not be read as independent causal contributions. Holt–Winters and ARIMA produced comparable accuracy (mean MAPE 4.6% vs. 4.7%). The five-year cancer prevalence pool reached 1,035,107 in 2023. Forecasting projects a total incidence of approximately 319,000 by 2028. Conclusions: Korean cancer epidemiology is undergoing a transition from infection-related cancers toward hormone-sensitive and screening-detectable malignancies. These findings support strategic resource allocation for high-growth cancers while maintaining vigilance over rising pancreatic and other emerging cancers.

IPC Classification

Keywords