Background: Cancer burden rises sharply with advancing age, and India’s rapidly aging population is expected to substantially increase the demand for geriatric oncology services. Despite this growing need, comprehensive long-term evidence describing trends, clinical characteristics, and outcomes among older adults remains limited. Robust registry-based analyses are essential to inform planning of age-appropriate cancer care and resource allocation.Objective: To evaluate temporal trends in geriatric cancer burden (1985–2024), describe clinical profiles (2017–2021), and assess survival outcomes of leading cancer sites (2017) using hospital cancer registry data. Methods: This retrospective study utilized data retrieved from electronic medical records and abstracted by trained registry staff using in-house OncoInsight software. Cancer sites were classified using ICD coding, and data abstraction was validated according to SEER standards. Temporal trends were analyzed using Joinpoint regression. Overall survival was estimated using the Kaplan–Meier method, and factors associated with survival were evaluated using Cox proportional hazards regression.Results: A total of 208,820 geriatric cancers were registered between 1985 and 2024, with the proportion of older adults increasing from 26.1% to 29.1% and a significant overall upward trend (AAPC 0.35*). The rise was greater among females (AAPC 0.56*) than males (AAPC 0.23*). Among males, prostate cancer showed the steepest increase (AAPC 3.34*), followed by stomach (1.51*), mouth (0.44*), and lung (0.84*), while oesophageal cancer declined significantly (−2.59*). Among females, gallbladder cancer increased most rapidly (AAPC 3.33*), followed by lung (8.47*) and ovary (1.50*), with breast cancer showing a modest increase (0.79*); cervical cancer declined significantly (AAPC −2.83*). Geriatric patients more frequently presented with advanced disease. Among geriatric males, distant metastases were common in lung (62%), stomach (44%), prostate (50%), and oesophagus (24%), whereas mouth predominantly presented at the regional stage (75%). Among geriatric females, distant-stage presentation was high for lung (75%), gallbladder (58%), and ovarian cancers (15%), while breast (52%) and cervix (74%) were most frequently diagnosed at the regional stage. Treatment completion was consistently lower in geriatric patients compared with younger adults. Among males, completion was lower for lung (48% vs 60%), stomach (45% vs 56%), mouth (36% vs 45%), and oesophagus (44% vs 58%), though prostate showed relatively higher completion (68% vs 74%). Among females, completion was lower for gallbladder (32% vs 39%) and lung (55% vs 65%), but comparatively higher for breast (64%) and ovary (72%). Median time to treatment initiation was similar across age groups (≈21–38 days). Surgery and radiotherapy were used less often in geriatric patients with localized and regional disease, whereas systemic therapy predominated in metastatic disease. Five-year overall survival among geriatric patients was 16.6% for lung, 59.7% for prostate, 68.6% for breast, and 56.8% for cervix. Survival was significantly poorer among patients with impaired performance status, advanced stage, palliative treatment intent, and those receiving single-modality therapy compared with patients aged 60–70 years, good performance status, early-stage disease, curative intent, and multimodality treatment. Conclusion: Findings underscore the urgent need for structured geriatric oncology services, individualized treatment approaches, and supportive interventions to improve treatment uptake and outcomes among older adults in India
 

Figure 1:Forest plot depicting Trends in Geriatric Cancer Cases registered at TMC, Mumbai (1985-2024)