Cancer cases among Dutch over-80s to surge, older patients benefit less from treatment

The number of cancer diagnoses among Dutch citizens aged 80 and older is set to rise sharply in the coming years, the Integraal Kankercentrum Nederland (IKNL) and Erasmus University Rotterdam warn. Researchers predict an annual increase of roughly 5 percent, potentially reaching 32,600 new diagnoses per year by 2032.

This growth is primarily driven by the aging of the Dutch population. Between 1989 and 2019, cancer cases among 80-plussers accounted for 16 percent of all tumors. By 2019, that share had risen to 25 percent. In comparison, the annual growth in diagnoses for this age group during 1989-2019 was 2.7 percent.

Men over 80 are most frequently diagnosed with skin, prostate, lung, bladder, and colorectal cancers. Women in the same age group are primarily affected by skin, breast, and colorectal cancers. The share of older patients is increasing most rapidly for lung cancer, melanoma, and asbestos-related cancers, reflecting prior exposure to risk factors such as smoking, sun, and asbestos.

Research also shows older patients benefit less from advances in cancer treatment. The use of systemic therapies, intended to prevent metastasis over the long term, rose overall from 12 percent to 34 percent between 1990 and 2019. For patients aged 80–84, usage increased from 3 percent to 15 percent, and for those 85–89, from 2 percent to 7 percent. Among patients over 90, nearly half receive no tumor-directed treatment, compared with 13 percent of younger patients.

Five-year survival improved for all age groups between 1990 and 2019, but the gains were much smaller for the oldest patients. Those under 80 saw survival rise by 19 percentage points, reaching 63 percent in 2019. Among 80-plussers, five-year survival increased by only 7 percentage points, to 26 percent in 2019.

“Older patients make different decisions regarding treatment, which is understandable,” said Melinda Schuurman, senior researcher at IKNL. “A well-organized approach that balances quality of life and life extension is essential. Proactive care planning can also play a role.”