Healthspan, Lifespan, and Cancer: Cancer in an ageing population

 

Healthspan, Lifespan, and Cancer: Cancer in an ageing population

A Think Piece for World Cancer Day 2026

Dr Esra Hassan

We are living longer than ever before. Across much of the world, reaching our 80s and 90s is becoming the norm. But longevity comes with a reality we rarely discuss openly: cancer is increasingly becoming a disease of longevity.

The longer we live, the greater the chance that changes accumulate within our cells that may eventually lead to cancer. A century ago, infectious diseases dominated mortality statistics. Today, in many countries, cancer is at the forefront. This shift is not accidental. As we prevent deaths from other causes, cancer becomes more visible. We are now surviving long enough to encounter diseases that were once less common simply because people did not live to the ages where cancer risk peaks. In many ways, the better we become at preventing deaths from other causes, the more cancer we will see.

On World Cancer Day, this raises an important question. If longer lives are becoming the norm, do we need to rethink how we approach cancer?

Healthspan and Lifespan

Lifespan is increasing. Healthspan is not. Longevity science makes an important distinction between lifespan, how long we live, and healthspan, how long we live in good health. These two are no longer moving in parallel. In England, life expectancy is around 79–83 years, yet healthy life expectancy is only around 62–63 years. This means many people spend 10–15 years of their life living with chronic illness, disability, or multiple conditions. This gap is known as the healthspan gap. If longer lives are to be meaningful, protecting healthspan becomes just as important as extending lifespan.

Interventions targeting individual diseases often add only a few years to life expectancy. In contrast, strategies that target the biology of ageing itself may have the potential to extend healthspan and reduce the risk of multiple age-related diseases simultaneously. Ageing is the biggest risk factor for diseases such as cardiovascular disease, stroke, Alzheimer’s disease, type 2 diabetes, frailty, and cancer. A majority of cancers occur in people over 50. This is because the biological processes that allow us to live for many decades, such as cell division, repair, and adaptation, also create opportunities for error over time. As populations age, cancer becomes less rare and more of a predictable part of the disease landscape.

What ageing really is: a biological process

Ageing is not simply time passing. It is a measurable biological process involving accumulated molecular damage, declining cellular repair, chronic low-grade inflammation, reduced immune surveillance, and loss of physiological resilience. Scientists describe this through the hallmarks of ageing, including genomic instability, telomere attrition, mitochondrial dysfunction, and epigenetic alterations. These mechanisms are deeply connected to how cancers develop and progress. DNA damage accumulates, senescent cells release pro-inflammatory signals, and immune systems become less effective at detecting abnormal cells. On closer inspection, cancer and ageing research are far more connected than they often appear.

If we can treat ageing, can we delay many diseases at once?

Traditional medicine treats diseases one by one. Geroscience offers a different idea. Targeting the biology of ageing itself to delay multiple diseases simultaneously. Rather than viewing cancer purely as something that appears and must be treated, this perspective invites us to consider how maintaining physiological resilience across the lifespan may delay cancer onset, reduce vulnerability, and lessen its impact.

Interventions that improve the biology of ageing have the potential to extend healthspan, reduce frailty, and lower risk across many age-related conditions, including cancer. This includes restoring metabolic health, reducing chronic inflammation, supporting immune function, and improving cellular repair mechanisms through geroprotectors, which are interventions aimed at slowing biological ageing processes.

While research into pharmacological geroprotectors and biomarkers of ageing is advancing in animal and human trials, the strongest current evidence for improving healthspan comes from lifestyle. Regular exercise, a healthy diet, good sleep, avoiding smoking and excess alcohol, and maintaining social connections are all associated with reductions in all-cause mortality and improvements in overall resilience.

Cancer: a barrier to healthy ageing

Many people spend the last decade of life in poor health, and cancer is often part of that story. Even when treatment is successful, the physical and psychological impact can affect quality of life, independence, and wellbeing, particularly in older age. If we want longer lives to also be healthier lives, cancer must be addressed earlier and more effectively than ever before. This means shifting the conversation from treatment alone to prevention, awareness, and early diagnosis. However, our health systems were not designed for a longevity reality.

Most healthcare systems were built around responding to illness once symptoms appear. Yet early-stage cancers often have vague or no symptoms at all. Screening programmes frequently have strict age cut-offs, and detection remains largely reactive rather than proactive. In a world where people routinely live into advanced age, waiting for symptoms may no longer be sufficient. Early diagnosis is not just a cancer strategy; it is a healthspan strategy. Detecting cancer earlier improves survival, reduces treatment burden, and preserves independence and quality of life.

The future of cancer care must take longevity into account. This means more personalised approaches to screening, greater awareness of early symptoms, systems that make early diagnosis easier and more accessible, embedding cancer prevention into how we think about ageing from early life onwards, and addressing inequalities that shape both ageing and cancer risk.

Conclusion

One of the challenges of cancer in the 21st century is, in many ways, the challenge of longevity itself. On this World Cancer Day, perhaps the question is not only how we treat cancer better, but also how we design a world where longer lives do not automatically mean more years lived with cancer and chronic illness.

Rather than seeing cancer purely as something that appears and must be treated, this perspective invites us to consider how maintaining physiological resilience across the lifespan may delay cancer onset, reduce vulnerability, and lessen its overall impact. Protecting healthspan may be one of the most important cancer strategies of the future.