Long working hours, demanding careers and pressure to perform often push health concerns to the background. Yet a troubling trend is emerging: cancer is increasingly affecting people under the age of 50.
In 2024, the National Cancer Society Malaysia (NCSM) observed a concerning rise in cancer diagnoses among adults under 50. Most cases occur in the 45-49 age bracket, but younger adults are far from immune.
Consultant clinical oncologist Dr Nur Adila Mokhtar said awareness and early action can make a critical difference. Understanding that cancer does not discriminate by age empowers young Malaysians to recognise symptoms early, when treatment is most effective and outcomes significantly better.
Lifestyle factors play a major role. Diets high in ultra-processed foods, red meat and sugar-sweetened beverages, combined with increasingly sedentary routines, contribute to metabolic dysfunction. Malaysia also has one of the highest obesity rates in Asia, and excess body weight is linked to at least 13 types of cancer.
Environmental factors further compound the risk. Urban air pollution, workplace chemical exposures, chronic stress from hustle culture and disrupted sleep patterns all add to cumulative cancer risk.
Adila identified gastrointestinal cancers, particularly colorectal cancer, as a growing concern.
“Colorectal cancer has become one of the most frequently diagnosed early-onset cancers worldwide, prompting many countries to lower the recommended screening age,” she said.
She also noted rising incidence of gynaecological, urological, thyroid, and head and neck cancers among younger populations.
Beyond lifestyle, genetics can significantly increase risk. Some young adults carry inherited mutations such as BRCA1 and BRCA2, associated with breast and ovarian cancer, or Lynch syndrome, linked to colorectal and other cancers.
“A strong family history of cancer, especially when it occurs at young ages, affects multiple relatives, or involves related organs, may signal an inherited predisposition,” Adila said. Identifying those at risk allows for genetic counselling, earlier screening and, in some cases, preventive intervention.
She emphasised that warning signs are often found in persistence and patterns rather than isolated symptoms. Any symptom lasting more than two to three weeks, worsening over time or interfering with daily life should prompt medical review.
Gastrointestinal symptoms are frequently dismissed. Persistent changes in bowel habits, rectal bleeding, or altered stool consistency are often attributed to haemorrhoids, delaying colorectal cancer diagnosis.
Unexplained weight loss, ongoing fatigue and loss of appetite are also commonly overlooked, particularly among young adults juggling multiple commitments. When these symptoms persist without clear cause, further investigation is warranted.
For women, breast changes such as new lumps, skin dimpling, nipple inversion or unusual discharge may be dismissed due to the misconception that breast cancer affects only older women. Abnormal vaginal bleeding, including bleeding between periods or after intercourse, is also often normalised.
In men, testicular lumps or swelling may be ignored due to embarrassment or lack of awareness, despite testicular cancer being one of the most common cancers in young men. Painless lumps in the neck, armpit or groin can also signal early lymphoma or other malignancies.
“In Malaysia, where healthcare access is widely available, early consultation can make a critical difference,” Adila said. “Being young should never be a reason for symptoms to be dismissed.”
Rising early-onset cancer rates are prompting reassessment of screening guidelines. While routine screening is usually unnecessary for those under 30 or 40, screening becomes essential for individuals with strong family history, hereditary syndromes or significant risk factors.
Tailored screening may include earlier colonoscopies, breast imaging for high-risk women, and liver surveillance for those with chronic hepatitis infections.
Cervical cancer screening should begin at age 21 for sexually active women, while HPV vaccination is most effective between ages nine and 14. Men are encouraged to practise testicular self-examination.
“Awareness should lead to vigilance, not fear,” Adila said. While cancer risk remains relatively low in young adults, early detection offers better outcomes, fewer complications and greater chances of recovery.
“Be aware, be proactive, but continue to live fully. Being young is not a barrier to cancer, but it is a strength when it comes to recovery and resilience.”