ObjectiveTo analyze the epidemiological characteristics of hepatitis C incidence and incidence trend from 2012 to 2023 and predict the incidence for 2024 – 2025 in Gansu province for the development of hepatitis C prevention and control strategies among local residents. MethodsData on hepatitis C incidence reported in Gansu province from 2012 to 2023 were collected from the Infectious Disease Reporting Information Management System of the Chinese Center for Disease Control and Prevention. A descriptive analysis of the epidemiological characteristics of hepatitis C incidence in Gansu province was conducted, and both the GM(1,1) model, linear and nonlinear curve regression analysis were performed to fit the annual incidence of hepatitis C. The optimal model was selected to predict the incidence of hepatitis C incidence for 2024–2025 among residents of Gansu province. ResultsDuring the 12-year period, a total of 83 306 hepatitis C cases were reported in Gansu province, with an average annual incidence rate (1/100 000) of 26.53 and annual specific incidence rates of 34.93, 29.10, 25.87, 30.21, 24.28, 29.71, 29.47, 28.04, 23.40, 22.49, 19.62, and 21.29 for the years from 2012 to 2023, respectively. There was an overall downward trend in the hepatitis C incidence rate during this period (χ2trend = 458.167, P = 0.006), with an average annual decrease of 1.13%. The average annual incidence rate of hepatitis C varied significantly among different regions of the province (χ2trend = 431.086, P = 0.007), with the top three average annual incidence rates of 96.78, 63.62, and 34.13 for Wuwei, Zhangye, and Lanzhou municipalities. The average annual incidence rate of hepatitis C for the male population (31.27) was significantly higher than that for the female population (19.36) (χ2 = 307.512, P = 0.008) and the rate differed significantly among the populations of different age groups (χ2trend = 53.104, P = 0.007), with the highest rate (46.13) for the population aged 45 – 54 years. The majority of the hepatitis C cases reported during the period (51 928, 64.48% of the total) were among farmers. Comparison of two models to fit the incidence data showed that the GM(1,1) model, with a mean absolute error (MAE) of 525.3 and a mean absolute percentage error (MAPE) of 0.06%, outperformed the quadratic curve regression model, which had an MAE of 551.0 and a MAPE of 0.07%, indicating a better fit of the GM(1,1) model. Based on the GM(1,1) model analysis, the predicted number of hepatitis C cases in Gansu province would be 5 958 in 2024 and 5 801 in 2025, with a declining trend. ConclusionThe incidence of hepatitis C in Gansu province from 2012 to 2023 showed a decreasing trend, with a higher incidence rate among males, people aged 45 – 54 years, and farmers. The GM(1,1) model performs well in predicting the incidence trend of hepatitis C. The results suggest that comprehensive preventive measures against hepatitis C should be taken.