The Rise of Colorectal Cancer Among Younger Malaysians

Understanding the Risk Factors and Symptoms for Early Detection and Treatment

Colorectal cancer is the most common cancer among men in Malaysia and the second most common among women. While it has long been associated with older adults, there is now an alarming increase in cases among people in their twenties to fifties.

A key concern in colorectal cancer in Malaysia is that many patients are diagnosed at later stages, leading to poorer treatment outcomes and greater pressure on the healthcare system. Early detection through colorectal cancer screening in Malaysia can significantly improve survival and reduce the need for palliative care.

A Cross-Gender Issue: Colorectal Cancer is Impacting Younger People More

Dr Khong Tak Loon, Colorectal Surgeon at SJMC.

Dr Khong Tak Loon, a colorectal cancer specialist at Subang Jaya Medical Centre, notes that both men and women are affected, with a higher risk observed in the Chinese population. According to the Malaysia National Cancer Registry Report, the rate of colorectal cancer in those over 50 has not declined, unlike in countries such as the United Kingdom and the United States, where active screening efforts have helped reduce cases.

What is more worrying is the growing number of colon cancer diagnoses in young adults aged 20 to 40. These individuals are often in the most productive years of their lives. Public awareness was heightened by the death of actor Chadwick Boseman at the age of 43 from colon cancer. The message is clear: early detection and prevention must be prioritised for all age groups.

Understanding Risk Factors and Lifestyle Triggers

Dr Khong explains that everyone has a five per cent lifetime risk of developing clinical colorectal cancer, meaning one in twenty Malaysians will be affected. Risk factors include:

• Diets high in red or processed meat
• High sugar consumption
• Lack of vegetables and fibre
• Smoking and alcohol use
• Sedentary lifestyle

These risk factors can contribute to inflammation, abnormal cell growth, and reduced gut health, all of which increase the chances of developing colorectal cancer symptoms.

Younger Patients Often Face a More Aggressive Form

In younger patients, colorectal cancer tends to progress more aggressively. Symptoms may be vague or attributed to general stomach issues, leading to delayed diagnosis. Tumours in younger individuals often grow faster and are more likely to spread to other parts of the body.

This results in a longer and more challenging colorectal cancer treatment journey, often requiring a combination of surgery, chemotherapy, and radiotherapy. According to Dr Khong, the stage of colorectal cancer diagnosis significantly affects outcomes and quality of life.

Colorectal Cancer Survival Rates by Stage

The chances of survival are closely linked to early detection:

• Stage I: 90% survival rate
• Stage II: 75% to 80% survival rate
• Stage III: 60% to 70% survival rate
• Stage IV: Below 15% to 20% survival rate

Early detection through colorectal screening and timely treatment is vital for improving cure rates and survival outcomes, says Dr Khong. 

Screening Methods That Save Lives

Early colorectal cancer diagnosis allows for more effective and less invasive treatment. Two key screening methods are available in Malaysia:

• Immunochemical Faecal Occult Blood Test (iFOBT): A simple and painless test to detect hidden blood in stool. If abnormalities are found, further tests, such as a colonoscopy, are carried out to confirm the presence of colorectal cancer or polyps.
• Colonoscopy: This is the most accurate method for detecting early-stage colorectal cancer. Advancements in medical technology have made colonoscopy a safe and well-tolerated procedure, commonly performed in most endoscopy units.

These tools make colorectal cancer screening in Malaysia accessible and potentially life-saving when done regularly.

Colorectal cancer is preventable.

Surgery Remains the Gold Standard Treatment

Surgery for colorectal cancer remains the first-line treatment. With the help of advanced robotic surgery systems, surgeries are now more precise and less invasive, especially in sensitive areas like the pelvic region. This improves outcomes, particularly for male patients.

Other treatments such as chemotherapy, radiotherapy, targeted therapy, and immunotherapy are also available in Malaysia to support colorectal cancer treatment and improve survival while reducing side effects.

Dr Khong addresses a common fear: not all surgeries result in a stoma or colostomy bag. In most cases, the bowel ends are reconnected after tumour removal. For patients who do require a stoma, counselling and support services are available to guide them through the adjustment process.

Colorectal Cancer Prevention Tips

Preventing colorectal cancer begins with daily choices:

• Eat more vegetables, fruits, and whole grains
• Limit red and processed meats
• Exercise regularly
• Avoid smoking and reduce alcohol consumption
• Schedule regular health screenings, especially after age 45

Know When to See a Doctor

Be alert to colorectal cancer symptoms such as:

• Changes in bowel habits
• Blood in the stool or changes in its shape
• Ongoing stomach discomfort
• A sense of incomplete bowel movement
• Unexplained weight loss or fatigue

These symptoms may seem minor, but can be early signs of colon cancer. Prompt medical attention is crucial for early detection.

Colorectal Cancer Is Preventable and Treatable

Dr Khong urges the public to remove the stigma surrounding colorectal cancer in Malaysia. With increased awareness and regular screening, this disease can often be detected early and treated successfully. Patients who are diagnosed at an early stage can enjoy a full recovery and return to their daily routines.

Source: Nan Yang Siang Pau