Abstract
Objectives: To evaluate the incidence and mortality of gastrointestinal cancers among older adults in Iran and to project their future burden through 2050.
Design: Population-based study.
Setting: National-level epidemiological analysis in Iran using data from the Global Cancer Observatory database.
Participants: Individuals aged 60 years and older diagnosed with major gastrointestinal malignancies, including esophageal, stomach, colorectal, anal, liver, gallbladder, and pancreatic cancers.
Outcome Measures: Estimated numbers of incident cases and deaths, age-standardized incidence and mortality rates (ASIRs and ASMRs), sex-specific distributions, and mortality-to-incidence ratios (MIRs), along with projected incidence and mortality estimates through 2050, were reported. In addition, Spearman’s rank correlation analysis was performed to evaluate the association between incidence and mortality across major gastrointestinal cancer sites. A P-value of less than 0.05 was considered statistically significant.
Results: In 2022, a total of 29704 new gastrointestinal cancer cases and 24900 gastrointestinal cancer-related deaths occurred among individuals aged ≥60 years in Iran. The overall ASIR and ASMR were 312.5 and 259.3 per 100000 population, respectively. Men accounted for 62.23% of incident cases and 59.94% of deaths. Stomach cancer was the most common gastrointestinal malignancy. Liver, esophageal, and pancreatic cancers demonstrated disproportionately high mortality relative to incidence. By 2050, the number of new gastrointestinal cancer cases among older adults is projected to increase to over 100000 cases, while gastrointestinal cancer-related deaths are expected to rise to over 92500, with increases of more than 240% and 270%, respectively. Sensitivity analyses showed stable cancer-ranking patterns and consistent MIR estimates across alternative projection scenarios. A very strong positive correlation was observed between ASIRs and ASMRs across gastrointestinal cancer sites among older adults in Iran, indicating that gastrointestinal cancers with higher incidence account for correspondingly higher mortality burden.
Conclusions: The burden of gastrointestinal cancers is rapidly increasing among older adults in Iran, and the projected rise of incidence and mortality by 2050 highlights the urgent need for comprehensive prevention strategies, early detection programs, and expansion of geriatric oncology services to address the growing cancer burden in the aging Iranian population.