Colorectal cancer (CRC) is a pervasive and life-threatening disease that affects millions of people worldwide.
Developing in the colon or rectum, which are critical components of the digestive system, CRC is on the rise among young Malaysian adults.
This is a trend that is particularly concerning as the disease has traditionally been associated with older people.
With an estimated 6,000 new cases being diagnosed each year, CRC has become a significant public health issue in Malaysia.
According to the Health Ministry’s Malaysia National Cancer Registry Report 2012-2016, the incidence of the disease was highest among Chinese, followed by Malays and Indians.
Common risk factors
One of the primary factors that is likely to be contributing to the increasing incidence of CRC in young adults in Malaysia is our changing diet and lifestyle.
Many Malaysians now consume more processed and high-fat foods, which are low in fibre and other essential nutrients.
Lack of physical activity and a sedentary lifestyle are also contributing factors to the development of CRC.
Many young adults spend long hours sitting in front of the computer or television, leading to a lack of physical activity.
Obesity is another known risk factor for CRC, and the rise in obesity rates in Malaysia may be linked to the increasing incidence of the cancer.
Addressing these dietary and lifestyle factors is crucial to reducing the incidence of CRC in Malaysia, particularly among young adults.
Genetics also play a role as certain mutations can increase the risk of developing CRC, which can be inherited from a parent.
Understanding the contribution of these factors to the development of CRC is critical to identifying higher-risk individuals and developing targeted prevention strategies.
Unfortunately, many young adults are not aware of the risk factors for CRC and may not seek screening until they experience symptoms.
Even then, symptoms such as rectal bleeding, abdominal pain and changes in bowel habits are often ignored or attributed to other causes.
General symptoms
It is important to be aware of the systemic symptoms that may indicate CRC.
These symptoms not only affect the colon, but can also affect the entire body.
However, it may be difficult to associate them with CRC due to their general nature.
Some of the symptoms to watch out for include unexplained weight loss, loss of appetite, nausea, vomiting, weakness and fatigue.
Despite their general nature, they should not be ignored as they serve as important warning signs.
It is worth noting that these symptoms can also be indicative of other health conditions, which is why it is important to seek medical attention and undergo appropriate testing to rule out other issues.
Regular screening starting at age 45 is recommended for individuals who are at average risk of developing CRC.
Individuals with a family history of CRC or other risk factors, such as inflammatory bowel disease (IBD) or genetic syndromes, may be recommended to start screening at an earlier age.
Although CRC symptoms may mimic non-cancerous gastrointestinal disorders or other non-cancerous conditions, it is recommended to schedule consultations with your healthcare provider at an earlier age.
Even though these symptoms may be due to a non-cancerous condition, it is important to be mindful of any changes in your health and seek medical attention promptly if you experience persistent symptoms.
Other less common CRC symptoms include sharp abdominal pain, bloating, severe constipation, stools that appear narrower or thinner than usual, continuous fatigue, iron deficiency that doesn’t improve with treatment, and gradual weight loss.
Such symptoms should never be ignored as they could indicate a more serious underlying issue.
Although these symptoms, like the ones mentioned earlier, may suggest another condition, seeking medical attention is crucial to rule out the possibility of CRC.
A doctor can run the appropriate tests to make an accurate diagnosis and provide proper treatment.
Diagnosis and treatment
Early detection is crucial for optimal treatment outcomes, hence individuals experiencing such symptoms should promptly seek medical attention.
Diagnostic tests for CRC include a biopsy, blood tests to detect signs of cancer or abnormalities, colonoscopy, flexible sigmoidoscopy, computed tomography (CT) colonography (also known as virtual colonoscopy), and faecal tests such as the faecal occult blood test (FOBT) and the faecal immunochemical test (FIT).
In cases where blood is not visible in faecal matter, a Guaiac-based faecal occult blood test (gFOBT) may be performed.
Additionally, a faecal DNA test can be done to detect genetic mutations and blood products.
The management of CRC is determined by factors such as the stage of cancer, the tumour’s location and the patient’s overall health.
The most common treatment for CRC is surgery.
The surgeon may opt for colonoscopy, laparoscopic surgery or open surgery, depending on the tumour’s position.
Additionally, treatments such as chemotherapy, radiation therapy, targeted therapy or immunotherapy may be administered depending on factors such as the stage of cancer and the patient’s overall health.
Targeted therapy involves drugs that target specific proteins or genes that promote the growth of cancer cells.
Meanwhile, immunotherapy stimulates the body’s immune system to attack cancer cells, and is often recommended for advanced CRC that has spread to other parts of the body.
It is important to note that the treatment options for CRC are personalised and should be decided upon in consultation with a medical professional.
Regular screening and check-ups are recommended, particularly for those with a family history of CRC, as early detection and diagnosis will improve the treatment’s effectiveness.
Minimising your risk
Although there is no foolproof method to prevent CRC, there are measures you can take to minimise your risk of developing the disease.
These include adopting a balanced diet that is rich in fibre, fruits and vegetables.
Regular exercise is also crucial – doing at least 30 minutes of moderate physical activity, such as brisk walking or cycling most days of the week can help reduce the risk.
Additional preventative measures include maintaining a healthy weight, abstaining from smoking and excessive alcohol consumption, and undergoing regular CRC screenings.
In conclusion, the CRC incidence rate among young adults in Malaysia has significantly increased over the years.
However, it is important to note that CRC is curable.
Early detection and diagnosis are crucial in improving treatment outcomes and increasing the chances of a cure.
While there are various treatment options available, prevention remains the best course of action.
Dr Jenson Sow is a clinical oncologist. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Already a subscriber? Log in
Get 20% OFF The Star Digital Access
Cancel anytime. Ad-free. Unlimited access with perks.
