SHAH ALAM - Cancer among adults under the age of 50 is becoming an increasingly recognised health concern in Malaysia, reflecting a global trend that can no longer be ignored.
Sunway Medical Centre, Sunway City (SMC) clinical oncologist Dr David Lee Dai Wee said early-onset cancer refers specifically to adult cancers diagnosed before the age of 50.
He noted that the trend is part of a broader global pattern, with a 2021 publication reporting an estimated 3.16 million new cases of early-onset cancers worldwide.
He said even though Malaysia does not yet have comprehensive national statistics, clinically, more patients under 50 are being diagnosed.
On the other hand, SMC’s emergency medicine specialist Dr Ian Tey Zhe Yuan said a concerning number of patients who visit the Accident and Emergency (A&E) department eventually turned out to have cancer, often after delaying medical attention.
“While some patients are already diagnosed cancer cases seeking urgent care, others arrive with symptoms such as persistent pain, breathing difficulties or unexplained complications only to later discover an underlying malignancy,” said Dr Tey.
Most common among younger adults and risk factors behind the surge
Dr Lee said breast cancer continues to dominate early-onset cases in Malaysia, consistent with its position as the most common cancer overall especially those under the age of 50.
“Delayed childbirth, fewer children, or lack of breastfeeding are recognised risk factors of breast cancers. These patterns are becoming more common in modern society,” he said.
Other cancers that are also appearing earlier than before includes colorectal cancer, nasopharyngeal cancer and lung cancer.
Dr Lee cautioned that a combination of interacting factors contributes to the rise in early cancer onsets, with lifestyle among key reasons.
He said sedentary lifestyles, lack of exercise and diets high in processed food are major contributors.
Commenting further, Dr Lee said environmental exposure, such as air pollution and microplastics, while use of more plastic in food packaging, drinks and daily consumption than ever could also be further contributing factors.
Early screening and investigation also plays a role
Despite the rise in numbers, Dr Lee said improved awareness and screenings through medical technology may also be contributing to higher detection rates.
He said people today are more health-aware and with better imaging tools and easier access to information, cancers are being detected earlier than in the past.
He added that younger generations are also more likely to seek medical advice through digital platforms and health education campaigns.
“Part of the increase is because we are simply picking up cases earlier and more effectively,” he said.
Dr Tey said patients who came in seeking emergency attention with cancer exhibiting symptoms will be stabilised first before proceeding with investigations, including blood tests and imaging such as X-rays or CT scans to determine the cause of the symptoms.
“Advanced imaging might suggest the presence or spread of cancer, but confirmation usually requires further specialist evaluation,” he said.
Once initial assessments are completed, patients are referred to the appropriate specialists, such as surgeons or oncologists, for further diagnosis and treatment.
Misconceptions about cancer remain widespread
Among the key misconceptions about cancer is that it only affects older people, while ignoring early warning signs, said Dr Lee.
There is also a perception that cancer is always fatal.
“There is still a lot of fear. Some patients avoid hospitals or feel hopeless when they hear the word 'cancer',” he said.
However, he stressed that early-stage cancer is often highly treatable.
He said in many cases, if detected early, cancer is not a death sentence. He said it can be treated successfully and sometimes even cured.
Refer to GPs for early diagnosis
Dr Tey emphasised that A&E departments are designed to handle urgent and critical cases, not routine symptom checks.
Instead, he advised that individuals with persistent but non-critical symptoms should first seek care at primary healthcare centres such as general practitioners (GPs).
“Symptoms like a lump, unexplained weight loss or mild bleeding are warning signs, but they are not immediately life-threatening.
“Primary care doctors are better positioned to coordinate care, arrange follow-ups and refer patients to the right specialists,” he said.