Cancer burden among adults aged 65 years and older in Asia, 1990–2023: a systematic analysis of the Global Burden of Disease Study 2023

Older adults bear a substantial and increasing share of the cancer burden in Asia, yet its temporal trends, geographical heterogeneity, and inequalities remain insufficiently characterised. Using estimates from the Global Burden of Disease Study 2023, we assessed cancer incidence, mortality, and disability-adjusted life-years (DALYs) among adults aged 65 years and older across 34 Asian countries from 1990 to 2023, and examined demographic and epidemiological drivers, variations by location, sociodemographic index, age, and sex, with projections to 2050. In 2023, this population experienced 4.59 million new cancer cases, 3.27 million deaths, and 57.49 million DALYs. East Asia had the highest burden, whereas South Asia had the lowest rates but the fastest increases in incidence and mortality. Lung cancer remained the leading cancer, and digestive system cancers accounted for the greatest system-level burden. Population growth and population aging were the main contributors to rising cases and deaths, while favourable epidemiological changes were observed only in East and Southeast Asia. By 2050, the age-standardised incidence rate is projected to reach 1146.25 per 100,000 in females and 1518.97 in males. These findings call for more equitable and age-responsive cancer prevention and care strategies across Asia.