Aging and cancer in the Caribbean: Incidence and mortality trends among older adults during Covid-19: Population-based analysis from Martinique, 2008-2022

Background: Prostate, breast, stomach, colon-rectum, lung, and hematologic cancers represent a regional public health burden among older adults in the Caribbean. We analyzed 15-year trends in incidence and mortality among older adults in Martinique, including the COVID-19 period, to describe changes in cancer burden, screening and treatment. Methods: We conducted a population-based cohort study (2008-2022) from the population-based cancer registry of Martinique. Patient selection on all registered residents irrespective of nationality. Segi/WHO age-standardized incidence and mortality rates (ASR) were calculated using the world standard population and Annual Percent Change (APC) in patients ≥65 years, by tumor site and sex with 95% CI. Results: We recorded 15,400 incident cancers; 9,913 (64.4%) occurred in men. An indicating overall stability with a slight increase from the first to the later periods in age-standardized incidence rates (ASR per 100,000) were 847.80 (95% CI: 801.80-893.90) in 2008-2012 to 862.10 (821.2-903.0) in 2018-2022. Prostate cancer mortality declined; rising female breast cancer incidence with stable mortality; stable colorectal cancer incidence with varying mortality; and declines in stomach cancer incidence and male lung cancer mortality. Conclusions: Over fifteen years, cancer burden among older adults in Martinique patterns were consistent with Caribbean and global observations, with differences in magnitude and timing by site and sex, reflecting changing screening intensity, new therapeutics, and COVID-19 disruptions. These findings support tailored cancer control strategies for older adults, emphasizing equitable access to diagnostics and treatment, and resilience planning for service interruptions. Future research should integrate socioeconomic and comorbidity factors.