Rethinking Young Malaysians and Cancer: Why Age Doesn't Guarantee Immunity

Dismissing persistent fatigue as "just work stress," attributing unexplained weight loss to a busy lifestyle, or ignoring unusual symptoms because "I'm still young" has become somewhat of a second nature for many young Malaysians.

Realistically, with long working hours, demanding careers, and the pressure to constantly perform, health concerns often take a backseat. However, a troubling trend is emerging, whereby 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 in recent years. Among under-50 patients, most cases occur in the 45-49 age bracket, though younger adults are still far from immune.

Dr. Nur Adila Mokhtar, Consultant Clinical Oncologist at Sunway Medical Centre Damansara (SMCD), emphasises that awareness and early action can make all the difference. Understanding that cancer doesn't discriminate by age empowers young Malaysians to recognize important symptoms early, when treatment options are most effective and outcomes are significantly better.

What puts young Malaysians at risk?

Malaysia's rapid modernization has brought societal development, but also lifestyle changes that can influence rising cancer rates among younger populations. The transition from traditional diets rich in whole foods to ultra-processed foods, red meat, and sugar-sweetened beverages, coupled with increasingly sedentary lifestyles creates a foundation for metabolic dysfunction.

Besides that, Malaysia also has one of the highest obesity rates in Asia, and excess body weight is linked to at least 13 types of cancer. Urban air pollution, workplace chemical exposures, chronic stress from "hustle culture," and disrupted sleep patterns further compound these risks.

Amidst the more concerning trends among young adults, Dr. Adila identifies gastrointestinal cancers, particularly colorectal cancer, as one to keep an eye on. "Colorectal cancer has become one of the most frequently diagnosed early-onset cancers worldwide, prompting many countries to reconsider screening guidelines and lower the recommended age for screening," she explains. Dr. Adila also notes rising incidence of gynecological, urological, thyroid, and head and neck cancers among younger populations.

Beyond lifestyle, genetics also play a crucial role in risk factors. 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), that significantly increase cancer risk at younger ages.

"Family history remains a critically important factor in assessing cancer risk among young adults," Dr. Adila emphasizes. "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 that's passed down through generations." Identifying individuals with hereditary risk allows for tailored strategies such as genetic counselling, earlier and more intensive screening, and in some cases, preventive interventions.

When to Stop Saying "It's Probably Nothing"

Dr. Adila emphasizes that the key lies not in isolated symptoms, but in patterns and persistence. "Any symptom that lasts longer than two to three weeks, progressively worsens, or interferes with daily life should prompt medical review.” she explains.

Among younger patients, Dr. Adila notes that gastrointestinal symptoms are frequently dismissed. "Persistent changes in bowel habits, such as ongoing diarrhoea, constipation, changes in stool consistency, as well as rectal bleeding are often attributed to haemorrhoids, leading to delayed evaluation of colorectal cancer," she explains.

Unexplained weight loss, persistent fatigue, or loss of appetite are also commonly overlooked, especially among busy young adults juggling multiple commitments. "These symptoms are often attributed to stress, lack of sleep, or burnout. However, when they persist without an obvious cause, they warrant further investigation," Dr. Adila cautions.

For women, breast changes such as new lumps, skin dimpling, nipple inversion, or unusual discharge are sometimes dismissed due to the misconception that breast cancer only affects older women. Abnormal vaginal bleeding, including bleeding between periods or after intercourse, is also often normalized, delaying assessment for gynaecological cancers.

Whereas 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 anywhere in the body, particularly in the neck, armpit, or groin, should also raise concern, as persistent lymph node enlargement can be an early sign of lymphoma or other malignancies.

"In Malaysia, where access to healthcare is widely available through both public and private sectors, early consultation can make a critical difference," says Dr. Adila. "Young individuals should feel empowered to advocate for themselves, request further evaluation when symptoms persist, and seek second opinions if concerns remain unresolved. Being young should never be a reason for symptoms to be dismissed."