Background <p>Malignant tumors are one of the most challenging public health problems facing mankind. It is of great significance to systematically, comprehensively, and fully understand and analyze the prevalence and distribution of malignant tumors in the elderly population.</p> Aims <p>To evaluate the prevalence and associated factors of malignant tumors in the elderly population in China, and quantify the differences in prevalence and associated factors by urban and rural area, sex, and age.</p> Method <p>The data is based on Chinese citizens aged 60 and above, using a self-weighted sampling design of stratified, multi-stage, Probability Proportionate to Size Sampling (PPS), and equal-probability sampling at the end of the stage. The analysis included 224,142 valid questionnaires.</p> Results <p>Among the 215,041 elderly people who participated in the survey, a total of 2,463 participants reported the diagnosis of malignant neoplasms, with a prevalence rate of 1.2%. Urban and rural areas, marital status, living alone, drinking, medical insurance, income, education level and economic status were associated with malignant tumors. Rural household registration, living alone, moderate alcohol consumption, without medical insurance and having income were associated with a lower prevalence of malignant tumors.</p> Conclusions <p>The prevalence of malignant tumors in urban residents is higher than that in rural residents. There was no significant difference in the overall prevalence of malignancies between sexes. Urban residence, not living alone, higher education level, and poor economic conditions were found to be associated with a higher prevalence of malignant tumors among the elderly, while widowhood and moderate alcohol consumption appeared to be associated with lower prevalence.They could inform future prevention strategies for malignancies and highlight unresolved health disparities.</p>