Cancer in the Oldest-Old Population in the MENA Region: Epidemiology and Temporal Trends Based on GBD 2021

IntroductionCancer among the oldest-old (aged ≥85) is an escalating public health concern, particularly in the Middle East and North Africa (MENA), where demographic aging is advancing rapidly.MethodsWe analyzed cancer incidence and mortality trends among the oldest-old in MENA from 1990 to 2021 using Global Burden of Disease (GBD) 2021 data, and compared these trends to global patterns.ResultsCancer incidence and mortality among the oldest-old in MENA increased substantially, surpassing global trends. Between 1990 and 2021, incidence rose by 54.2% in MENA vs 25.3% globally, while mortality increased by 17.6% vs 3.1% globally. Females experienced steeper rises in both incidence and mortality. Annual percent change (APC) in MENA incidence was +1.96 (95% CI: 1.28-2.64) for females and +0.83 (95% CI: 0.59-1.08) for males, compared to +0.28 (95% CI: 0.18, 0.38) and +0.47 (95% CI: 0.40, 0.55) globally. APC for mortality in MENA was +1.27 (95% CI: 0.66-1.88) for females and +0.33 (95% CI: 0.12-0.54) for males, vs -0.07 (95% CI: -0.13, 0.0) and +0.11 (95% CI: 0.03, 0.18) globally. Leading cancers were prostate, lung, and colorectal for males, and breast, colorectal, and lung for females, with variation across countries.ConclusionThe rising cancer burden among the oldest-old in MENA underscores the urgent need for targeted interventions. Strengthening preventive measures, improving healthcare access, enhancing cancer registration, and implementing tailored screening and treatment strategies are critical. Policymakers must prioritize geriatric oncology and invest in healthcare infrastructure to ensure equitable, effective cancer care for the region's aging population.