The aim of this study was to assess whether there are differences in treatment strategy and outcome between different age cohorts among men and women with colon cancer.All patients with colon cancer included in the regional quality registry in Uppsala/Örebro and Stockholm between 1996 and December 2004 were analysed (n=11002). Patients were divided into three age categories: ≤65 years, 66–80 years and >80 years.Overall and cancer-specific survival decreased with increasing age for stages II and III colon cancer but was not influenced by gender. Older patients with stage III tumours were less likely to be referred for chemotherapeutic treatment and there was a decrease in cancer-specific survival with increasing age, from 63.7% to 51.0% to 38.4% in the three age groups. Postoperative morbidity and the number of reoperations was significantly higher in men than in women.The present study shows lower cancer-specific survival among older patients than among younger patients. Gender was not a prognostic factor in cancer-specific survival.