Objective To analyze the epidemiological characteristics of malignancy in the elderly over 60 years old in malignancy surveillance areas in Inner Mongolia Autonomous Region in 2018 and the incidence and mortality trends from 2013 to 2018.

Methods The malignancy registration data in the elderly in 2018 reported from 18 cancer surveillance areas in Inner Mongolia Autonomous Region were collected. The crude incidence/mortality rates, age-specific incidence/mortality, age-standardized incidence/mortality rates and the composition ratio stratified by urban-rural status and gender were calculated. The average annual percent changes in incidence/mortality rates from 2013 to 2018 was calculated by using joinpoint software.

Results In 2018, the new cases and deaths of cancer in the elderly in malignancy surveillance areas in Inner Mongolia accounted for 57.24% and 70.06% of the total cases and deaths in the whole population, respectively. The top 5 malignancies were lung malignancy, liver malignancy, colorectal malignancy, stomach malignancy, and esophageal malignancy, and the top 5 malignancies causing deaths were lung malignancy, liver malignancy, stomach malignancy, esophageal malignancy and colorectal malignancy. The incidence and mortality rates of malignancy in elderly men and elderly women showed downward trends from 2013 to 2018 average annual percent change (AAPC)=−3.58%, 95%CI: −5.42% – −1.71%, P<0.050; AAPC=−2.56%, 95%CI: −5.48%–0.44%, P=0.076. For both elderly men and elderly women, the incidence of the top 5 cancers showed downward trends, but more obvious decreases were observed for the incidence of liver malignancy in the elderly men (AAPC=−7.14%, 95%CI: −11.01% – −3.10%, P<0.050) and the incidence of lung malignancy in the elderly women（AAPC=−5.35%, 95%CI: −7.42% – −3.23%, P<0.050）.

Conclusion Lung malignancy and digestive malignancy were the main types of malignancy in the elderly in Inner Mongolia Autonomous Region, and there were significant differences in the incidence and mortality trends of the top 5 malignancies. So It is necessary to conduct targeted malignancy prevention and treatment according to the characteristics of the elderly population.