Whilst it is unclear why early-onset cancer cases are increasing, emerging hypotheses suggest that “biological age” in younger populations is outpacing chronological age due to environmental exposures. According to a prominent study, “Global trends in incidence, death, burden and risk factors of early-onset cancer from 1990 to 2019 are projected to increase by 31% and 21% in 2030 respectively.”
Though breast cancer remains the most-frequently diagnosed early-onset cancer globally, gastrointestinal cancers are showing the fastest growth. Cases of appendix cancer and Intrahepatic bile duct cancer respectively are increasing at an annual rate of 15.6% and 8.1% annually.
In addition, colorectal cancer (CRC) is now also the leading cause of cancer death for men under the age of 50, the second-leading cause for women in this age bracket, while people born in 1990 face two- to three times higher risk of developing pancreatic or gastric cancer compared to those born in 1955.
As global communities prepare to mark World Cancer Day 2026 on February 4, the Breast, Thyroid, and Parathyroid Centre Apffelstaedt, Hoosain & Associates (AHA) is urging South Africans younger than 50 years to pursue risk management and screening to push back against the early-onset cancer trends.
Surgeon and principal, Dr Fatima Hoosain, points out that while people are quick to check in with their families, places of work and WhatsApp groups, they frequently fail to do the same with their own bodies.
“Despite the rise in early-onset cancers, a culture of fear and silence pervades as citizens of the world attempt to put on a brave face on health challenges and fears, work pressures, troubled relationships, cultural expectations, and mental health concerns,” says Hoosain. ‘The situation is exacerbated by erroneous beliefs that cancers like colon cancer are an “older person’s disease”.
Hoosain emphasises that lifestyle factors remain key drivers of early-onset cancer. For example, excessive body fat contributes to at least 17 types of cancer and, when obesity is brought into the equation, the risk of early-onset CRC nearly doubles.
“Diets that are high in red meat and sodium and low in milk and fruits as well as alcohol and tobacco use all increase the risk of early-onset cancer,” she says.
“Our challenge is that aside from these risky lifestyle habits, unique challenges exist for younger patients. These include delayed diagnosis due to a low suspicion of cancer, work and financial pressures, parenting responsibilities, negative perceptions of body image and identity, mental health strains and long-term survivorship needs.”
Furthermore, breast- and thyroid-related fertility considerations, a lack of awareness of thyroid symptoms, misinterpreting soft tissue tumours as benign, and low screening uptake for colon cancer among younger adults are adding to the early-onset cancer trend.
30-year-old Merisca Hartzenberg is an example of an early-onset breast cancer diagnosis. Diagnosed with breast cancer in July 2024, like many younger women, she “never thought it would happen to me, especially since I work in an environment where I encounter people with different illnesses every day. Even though I had noticed possible symptoms of breast cancer, including a cyst, light pain and yellow discharge, at 29, I felt too young for that to be cancer. In fact, when I first approached my GP in March 2023 about a lump in my breast, I was referred for an ultrasound and mammogram but was denied the latter on the basis of being too young.”
Though the ultrasound revealed three cysts in her breast, no further action was taken.
When she visited another doctor, she was prescribed anti-inflammatories and sent on her way. It was only when a colleague referred her to Hoosain that proper screening and diagnosis occurred.
Hartzenberg’s treatment journey has included 16 cycles of chemo medication, a double bilateral mastectomy and 15 sessions of radiation.
“My experience has taught me that while online searches can give you information, nothing replaces getting checked by a doctor early on,” she says. “It’s also highlighted to me that cancer can affect anyone, regardless of age or background.”
Hoosain believes that younger South Africans need to know that the country boasts world-class facilities that offer screening and diagnostic processes and surgical care that are tailored to each person’s unique circumstances.
“Breast cancer prevention is enhanced via mammograms, ultrasound testing, clinical breast examinations, risk-based screening and genetic risk assessments,” says Hoosain. “The potential for thyroid cancer is mitigated by thyroid ultrasounds, fine needle aspiration, surgical management and long-term follow-ups.”
Screening, risk factors, symptoms, and referral pathways, especially for early-onset colon cancer trends, are also readily accessible.
She also states the importance of the self-check-in when it comes to breast, thyroid, and colon cancers.
“It’s about noticing changes and knowing your own normal,” she says.
“With breast cancer, for example, checking in means paying attention to new lumps, skin and nipple changes or anything that feels different. With thyroid cancer, it means recognising weight changes and neck swelling. Checking in means connecting the dots between subtle symptoms and a possible health challenge.”
These include bowel changes for colon cancer.
“Research shows that while cancer incidence is rising, overall mortality in younger adults is decreasing due to improved screening and treatment. This is why it is so important for younger South Africans to pursue them,” Hoosain adds.
