The oncogeriatric transition in Morocco: health-system challenges and strategic priorities in an aging society

Background: Morocco is experiencing rapid demographic aging alongside a rising cancer burden, creating structural challenges for the care of older adults with cancer. This review synthesizes current evidence on geriatric oncology in Morocco and proposes a conceptual framework to guide system-level adaptation. Methods: We conducted a structured narrative review of peer-reviewed publications, population-based registry data, national demographic reports, and policy documents published between 2000 and 2025 (last search: January 2026). Evidence was synthesized qualitatively and organized into six predefined analytical domains: (1) demographic transition, (2) cancer epidemiology, (3) health system organization, (4) access to care, (5) workforce capacity, and (6) geriatric assessment and clinical practice. These domains are applied consistently as the organizing framework across the Results sections and are explicitly mapped onto the WHO Health System Building Blocks and the Four-Phase Oncogeriatric Transition framework in the Discussion. Results: In 2024, adults aged ≥60 years accounted for 13.8% of Morocco's population, while individuals aged ≥65 years represented approximately 8%, with projections indicating a marked increase by 2050. Population-based registries report age-standardized cancer incidence rates around 120-137 per 100,000. Available cohorts indicate high vulnerability prevalence (e.g., >80% abnormal G8 in some series), substantial metastatic presentation at diagnosis, limited geriatric workforce capacity, and a strong urban concentration of oncology services. Structured geriatric assessment is not yet consistently implemented in routine oncology care. Conclusion: These findings suggest that Morocco is entering an oncogeriatric transition characterized by a growing mismatch between demographic acceleration and geriatric-integrated oncology capacity. We propose a Four-Phase Oncogeriatric Transition framework to conceptualize this evolution and inform policy, workforce planning, and phased implementation strategies. Early integration of geriatric assessment, registry adaptation, and multidisciplinary coordination will be essential to ensure equitable, age-adapted cancer care in an aging society.