# Cancer Mortality in an Ageing Population: Evidence of Sex-Specific Divergence from a National Study in Poland

## TL;DR

This study examines cancer mortality trends in older adults in Poland, revealing sex-specific differences, especially in lung and breast cancer deaths among women.

## Contribution

The study identifies sex- and age-specific cancer mortality trends in Poland, emphasizing the need for targeted prevention and care strategies.

## Key findings

- Cancer mortality declined among older men but remained variable among women.
- Lung cancer deaths increased in older women, while lung cancer mortality decreased in men.
- Breast cancer mortality rose in the oldest women, highlighting gaps in prevention and care.

## Abstract

Population ageing is leading to a growing burden of cancer among older adults, making it increasingly important to understand long-term mortality patterns in this age group. In this study, we analysed changes in cancer mortality among people aged 65 years and older in Poland over a 23-year period. We examined differences by sex, age group, and cancer type to identify which malignancies contribute most to mortality in early and late old age. Our findings show that cancer mortality has declined among older men but remains more variable among women, with rising deaths from lung and breast cancer in the oldest age groups. These trends reflect past differences in smoking behaviour, cancer prevention, and access to early diagnosis and treatment. By highlighting sex- and age-specific patterns, this study provides evidence to support more targeted cancer prevention, screening, and care strategies for ageing populations.

Background: Malignant neoplasms are a leading cause of death among older adults, and population ageing is expected to further increase the cancer burden. Analysing long-term mortality trends is essential for evaluating the effectiveness of cancer prevention and oncological care. The aim of the study was to analyse long-term trends in mortality from malignant neoplasms among adults aged 65 years and older in Poland between 2000 and 2022. Methods: This nationwide population-based study analysed all deaths due to malignant neoplasms among Polish residents aged ≥65 years between 2000 and 2022 using national mortality data from Statistics Poland. Mortality trends were assessed separately for women and men in early (65–74 years) and late (≥75 years) old age. Standardised death rates (SDRs) were calculated using the European Standard Population. Joinpoint regression was applied to estimate annual (APC) and average annual percentage changes (AAPC). Results: Overall cancer mortality declined steadily among men in both age groups, while trends among women were heterogeneous. In men aged 65–74 years, SDRs decreased from 1140.1 to 1006.0 per 100,000 (AAPC = −1.7%), largely driven by declining lung cancer mortality (AAPC = −2.6%); similar patterns were observed in men aged ≥75 years. Among women aged 65–74 years, overall cancer mortality declined modestly (AAPC = −0.4%), but lung cancer mortality increased markedly, with SDRs nearly doubling between 2000 and 2022 (AAPC = 3.5%). Conclusions: Sustained declines among men contrast with less favourable trends among women, particularly for smoking-related cancers, highlighting the need for targeted prevention, screening, and age-adapted oncological care.