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

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.