FOR decades, colorectal cancer was regarded as a disease that mainly affected older adults. Today, however, this perception is changing rapidly. Across the world, including Malaysia, an increasing number of young adults are being diagnosed with colorectal cancer, often in the most productive years of their lives. This emerging trend should concern every Malaysian because early detection remains our most powerful tool to save lives.
Recent reports indicate that colorectal cancer is now one of the most common cancers in Malaysia, with an increasing proportion of cases occurring in individuals under the age of 40. Unfortunately, many of these young patients are diagnosed at an advanced stage, when treatment becomes more complex and survival rates are lower. This highlights an urgent need to improve public awareness and encourage earlier medical evaluation.
One of the reasons for delayed diagnosis is the common misconception that colorectal cancer is ‘an older person's disease’. As a result, young adults – and sometimes even healthcare providers – may overlook early warning signs or attribute symptoms to less serious conditions such as haemorrhoids, irritable bowel syndrome, or dietary changes. Consequently, valuable time is lost before the correct diagnosis is made.
Although researchers continue to investigate why colorectal cancer is becoming more common in younger people, several well-established risk factors have been identified. These include diets rich in processed and red meat, low fibre intake, obesity, physical inactivity, smoking, excessive alcohol consumption and certain inherited genetic conditions such as Lynch syndrome and familial adenomatous polyposis. A family history of colorectal cancer also significantly increases an individual's risk and should never be ignored.
The encouraging news is that colorectal cancer often develops slowly over several years, usually beginning as small precancerous polyps in the lining of the colon or rectum. These polyps can be detected and removed during screening colonoscopy before they become cancerous. This makes colorectal cancer one of the few cancers that is not only treatable when detected early but also largely preventable.
Every Malaysian should be aware of the warning symptoms that warrant prompt medical attention. These include persistent rectal bleeding, blood in the stool, changes in bowel habits lasting more than a few weeks, unexplained abdominal pain, unexplained weight loss, persistent fatigue and iron-deficiency anaemia. While these symptoms do not always indicate cancer, they should never be dismissed, particularly if they persist or recur.
Fortunately, survival rates for colorectal cancer are excellent when the disease is diagnosed early. Patients with localised disease have a very high chance of successful treatment and long-term survival. Conversely, once the cancer has spread to distant organs, treatment becomes more challenging and the prognosis is significantly less favourable. This simple fact reinforces the importance of recognising symptoms early and seeking timely medical care.
Prevention remains our strongest defence. A healthy lifestyle can substantially reduce the risk of colorectal cancer. Eating a diet rich in fruits, vegetables, whole grains and other high-fibre foods, maintaining a healthy body weight, exercising regularly, avoiding smoking, limiting alcohol consumption and participating in recommended screening programmes are practical steps that every individual can take. People with a strong family history of colorectal cancer or inherited cancer syndromes should discuss earlier and more frequent screening with their healthcare provider.
Awareness should also extend beyond individuals. Families, schools, universities, employers, healthcare professionals, and policymakers all have important roles in promoting cancer education and encouraging healthy lifestyles. Public health campaigns should emphasise that colorectal cancer can affect younger adults and that persistent symptoms deserve proper medical evaluation regardless of age.
As medical professionals and educators, we have a shared responsibility to challenge outdated misconceptions and empower the public with accurate knowledge. Colorectal cancer is no longer a disease confined to older adults. By recognising the changing pattern of this disease, encouraging healthy lifestyles, and promoting early diagnosis, we can reduce its burden on Malaysian families and improve survival for future generations.
The message is simple yet powerful: Do not ignore the warning signs because of your age. Early detection saves lives,and awareness is the first step towards prevention.
Assoc Prof Dr Omar Emad Ibrahim is an Associate Professor of Pathology and Cancer Research Group Leader at the International Medical School, Management and Science University (MSU).
