Immunity may play a role in preventing cancer progression. We studied associations of immune‐related conditions with cancer‐specific mortality among older adults in the United States. We evaluated 1 229 443 patients diagnosed with 20 common cancer types (age 67‐99, years 1993‐2013) using Surveillance Epidemiology and End Results‐Medicare data. With Medicare claims, we ascertained immune‐related medical conditions diagnosed before cancer diagnosis (4 immunosuppressive conditions [n = 3380 affected cases], 32 autoimmune conditions [n = 155 766], 3 allergic conditions [n = 101 366]). For each cancer site, we estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for cancer‐specific mortality associated with each condition, applying a Bonferroni cutoff for significance (P < 5.1 × 10−5). Bayesian metaanalysis methods were used to detect patterns across groups of conditions and cancers. We observed 21 associations with cancer‐specific mortality at the Bonferroni threshold. Increased cancer‐specific mortality was observed with rheumatoid arthritis for patients with melanoma (aHR 1.51, 95% CI 1.31‐1.75) and breast cancer (1.24, 1.15‐1.33)), and with hemolytic anemia for bladder cancer (2.54, 1.68‐3.82). Significant inverse associations with cancer‐specific mortality were observed for allergic rhinitis (range of aHRs: 0.84‐0.94) and asthma (0.83‐0.95) for cancers of the lung, breast, and prostate. Cancer‐specific mortality was nominally elevated in patients with immunosuppressive conditions for eight cancer types (aHR range: 1.27‐2.36; P‐value range: 7.5 × 10−5 to 3.1 × 10−2) and was strongly associated with grouped immunosuppressive conditions using Bayesian metaanalyses methods. For older patients with several cancer types, certain immunosuppressive and autoimmune conditions were associated with increased cancer‐specific mortality. In contrast, inverse associations with allergic conditions may reflect enhanced immune control of cancer.