Cancer incidence rates increase as people get older [by about 2-fold as people age from their early 60s to late 70s and older]. This scale of increase applies in Australia and globally. The corresponding increase in cancer death rates as people get older is about 3-4 fold.

Population increases of around 25% are projected to occur over the next 30 years, with larger increases of more than two-fold occurring in the age range of 75 years and over. The effect of these demographic changes will be to increase:
• Overall numbers of cancers by about 60% in Australia and by about 80% globally.
• Overall numbers of cancer deaths by around 80% in Australia and 90% globally.

The proportion of cancers diagnosed in people aged 75 years or more will increase from around 30% now to 40% in Australia over the next 30 years and from around 20% now to 30% globally. Meanwhile the proportions of cancer deaths occurring in people aged 75 years or more will increase from about 47% now to 58% in Australia and from around 30% now to 38% globally.

As a consequence of these changes:
• Service capacity will need to increase substantially.
• Service providers will need to manage more terminal cases as a proportion of their active patient case loads and a greater proportion of their cases with multiple co-morbidities.
• Increasingly clinical protocols based on trial evidence from younger healthier patients will not be relevant and will need to be variable to best meet the variable needs of a more heterogeneous, frail and elderly patient population
• New information systems and evidence based approaches will be needed to guide changes in clinical practice.
• The mix of cancers and causes of cancer death will change and service planning will need to provide for this.