Global burden and regional inequalities of cancer in older adults from 1990 to 2021 and its projection until 2050

1990年至2021年全球老年人癌症负担及区域不平等状况及其至2050年的预测

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Abstract

BACKGROUND: Global ageing will further exacerbate the cancer burden, and the intersection of cancer and ageing represents an emerging and significant global public health challenge. METHODS: Based on the Global Burden of Disease 2021 (GBD 2021) data, we utilized the estimated annual percentage change and Joinpoint regression model to examine the temporal trends in the global cancer burden among elderly population from 1990 to 2021. Pearson's rank correlation analysis was conducted to assess the relationship between disease burden and the socio-demographic index (SDI). Furthermore, an autoregressive integrated moving average (ARIMA) model was employed to forecast future trends (from 2022 to 2050). RESULT: From 1990 to 2021, the incidence rate of cancer among the elderly population exhibited a continuous upward trend, with the steepest annual increase in high-SDI regions (AAPC = 1.03 (0.83-1.23)). During the same period, overall mortality rate experienced a decline, falling by -0.47 per year (95% CI -0.51 to -0.43) in high-SDI region. This pattern was projected to persist over the subsequent 28 years, and was most pronounced in high SDI regions. Cancer incidence in older adults positively correlated with SDI, while mortality displayed an "S-shaped" relationship as SDI increased. Furthermore, significant regional disparities and variations across age cohorts were observed, with the highest disease burden concentrated among individuals aged 70 to 79 years, yet incidence rose fastest in the 85-89 (AAPC = 0.72 (0.5, 0.95)) and 90-94 (AAPC = 0.82 (0.63, 1.01)) age groups. The expansion of the older adults demographic has emerged as the primary driver behind the escalating disease burden associated with cancer in this population. CONCLUSION: The global burden of cancer among elderly population was projected to increase. Consequently, there was an urgent need for more precise and effective strategies to mitigate this trend and alleviate the cancer burden in older adults.

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