Shifting Cancer Burden Toward Older Adults in South Korea: Age Stratified National Projections

Background

Rapid population ageing is expected to reshape the future cancer burden in South Korea. This study projected future disability-adjusted life years (DALYs) due to cancer, with particular attention to the contribution of older adults in the context of a super-ageing population.

Methods

We conducted a projection study using Bayesian age-period-cohort modelling with integrated nested Laplace approximations (INLA). Historical cancer DALY data for South Korea from the Global Burden of Disease study (1990–2023) were combined with population projections from Statistics Korea under low, medium, and high population scenarios. DALYs and DALY rates per 100,000 population were projected to 2040 by sex (total, male, female) and age group (all ages, 0–19, 20–64, and ≥65 years), using 5-year age-stratified inputs.

Results

Cancer burden is projected to rise substantially through 2040 in all population scenarios, driven primarily by older adults. Under the medium population scenario, total cancer DALYs increase from 2.18 million in 2020 to 4.08 million in 2040, while the DALY rate rises from 4,209 to 8,155 per 100,000. Across scenarios, total DALYs in 2040 range from 4.02 to 4.27 million. The burden among adults aged ≥65 years shows the steepest increase, from 1.19 million in 2020 to 3.07–3.27 million in 2040, and its share of total cancer DALYs rises from 54.4% to over 76%. In contrast, DALYs among those aged 0–19 years decline markedly, and those among adults aged 20–64 years remain stable or slightly decrease depending on the scenario. Absolute burden remains higher among males, but the relative increase is also substantial among females.

Conclusions

South Korea is likely to face a pronounced shift toward an older-age cancer burden over the next two decades. Future cancer control strategies should move beyond population-wide approaches and strengthen age-responsive prevention, treatment, survivorship care, and long-term service planning for older adults.

Key messages

• Population ageing will sharply increase cancer DALYs in South Korea by 2040, with older adults accounting for more than three-quarters of the burden.

• Future cancer control in South Korea should prioritize age-responsive prevention, care and planning to meet the growing burden in older adults.