Cancer and ageing

The world’s population is ageing rapidly. There are currently over 760 million people worldwide above the age of 65 years [i], representing over 9% of the global population. Estimates suggest that this proportion will rise to 1.6 billion people by 2050, with the greatest demographic shift seen in LMICs where the population of over-65s is projected to grow from 37 million in 2019 to 120 million in 2050. 

Cancer can develop at any age, but the incidence of cancer rises dramatically at a later stage in life. In fact, in 2022 about 53% of people who had cancer were 65 or older (GLOBOCAN 2022 data). This association is most likely due to the accumulation of risk factors for specific cancers, which increase with age and less effective cellular repair mechanisms (Source: WHO). This means that governments will need to develop a strategy to drive change for older adults with cancer as part of their commitment to achieving universal health coverage, ensuring that older adults are not left behind. 

How being older can affect cancer treatment

Age adds a layer of complexity to living with cancer. Many cancers in older people are diagnosed at a later stage, as early cancer symptoms can be mistaken for other conditions or minor illnesses associated with old age. As a result, cancer treatment often starts late, which increases the complexity of treatment, the likelihood of severe side effects and reduces the chances of a successful treatment outcome.   

Older adults are a very diverse group, with substantial differences in the physical, mental and emotional wellbeing of individuals of the same age. As a result, when planning cancer treatments, clinical teams need to take into account multiple factors such as whether these individuals have additional non-communicable diseases, such as high blood pressure or diabetes, and the physical fitness of individuals. Older patients can be more vulnerable to treatment toxicities that can significantly affect their quality of life (Source: ASCO). This makes the management of cancer and maintaining a patient’s quality of life more challenging.  

Treatment plans for older adults should be built on a geriatric cancer assessment, which brings together a patient’s preferences and capacities and expert support from a multidisciplinary team, in order to deliver care and maintain an individual’s quality of life. 

Driving change for older adults with cancer 

Given that cancer disproportionately affects older adults and that these individuals require a tailored package of prevention, treatment and support. With populations ageing rapidly worldwide, this paper examines the major challenges and how the cancer community can help drive progress for older populations.

Policy responses to meeting the needs of older people

With the increase of ageing populations and incidence of cancer worldwide, more practical research and action need to take place to adapt healthcare systems to be more patient-centric and inclusive of ageing populations to ensure healthy ageing for all.