December 8, 2024
An increasing number of adults are receiving a diagnosed of cancer before the age of 50, termed "early-onset cancer". A survey conducted by the Hong Kong Anti-Cancer Society (HKACS) found only 38% of Hong Kong residents have heard of early-onset cancer. The survey highlighted three major concerns among individuals aged 18-49: individuals with a family history/three risk factors still perceive themselves as being at low risk; highest resistance to reducing excessive red meat/processed meat consumption and quitting alcohol; belief that lifestyle changes yield greater benefit at an older age. HKACS recommends early prevention through dietary and lifestyle adjustments, coupled with regular cancer screening for high-risk individuals.
The medical sector defines early-onset cancer as cancer diagnosed in adults under 50, with breast, colorectal, cervical, endometrial, and prostate cancers being the most common types. Apart from heredity, acquired factors such as diet and lifestyle habits, and obesity are closely linked to the risk of early-onset cancer. Early-onset cancer cases have increased by nearly 40% in Hong Kong and 80% globally over the past 30 years.
To understand Hong Kong residents' awareness of early-onset cancer and their willingness to adopt risk-reducing behaviors, HKACS conducted a survey during September to November involving 455 cancer-free individuals aged 18 or above. Results showed just 38% of respondents were familiar with early-onset cancer. The survey exposed various misconceptions; with just 1% were able to correctly identify all common types of early-onset cancers. Heredity is not the only cause of early-onset cancer, but 32% believed it causes most of the early-onset cancers, while others associated prevention with increased sun exposure (31%), intermittent fasting (11%), strict vegetarianism (8%), taking various nutritional supplements (8%), and reducing air travel (4%). Additionally, only 5% reported practicing all six healthy habits in the past 6 months, including non-smoking, abstaining from alcohol, a diet rich in fruits and vegetables, no excessive intake of red meat, no excessive processed meat intake, and regular exercise.
The survey results from respondents aged 18-49 also revealed three major concerns:
Dr. Lam Ka On, Chairman of the Cancer Education Subcommittee of HKACS, points out there is a lack of awareness and many misconceptions among Hong Kong residents regarding early-onset cancer. Respondents aged 18-49 with a family history or three risk factors are considered as high- risk, yet they are unaware of their actual risk level. Many of them refuse or delay making behavioral changes, despite the fact that poor dietary and lifestyle habits can increase the risk of early-onset cancer at any stage.
Dr. Lam explains that early-onset cancer is not solely linked to hereditary. Among the WHO's five major cancer risk factors, smoking, alcohol consumption, poor dietary habits, and sedentary lifestyle/lack of exercise are all modifiable risk factors:
Modifiable Risk Factors | Risk | Recommendations |
Smoking | Smoking causes -about 20% of all cancers and about 30% of all cancer deaths -about 80% of lung cancers, as well as 80% of all lung cancer deaths -increases the risk for colon/ rectum cancers and other cancers
| Your health immediately benefits from quitting, and reduces the risks of lung cancer in the long run · Within 1 to 9 months, reduction in coughing and shortness of breath · In 10 years, the risk of dying from lung cancer is roughly half compared to that of a smoker
|
Drinking
| Consumption of alcoholic drinks Quit drinking. increases the risk of 6 cancer types up to 25%. These cancers include: mouth and pharynx cancer, oesophagus cancer, stomach cancer, colorectal cancer, breast cancer and liver cancer. | Quit drinking. |
Excessive red meat and processed meat consumption
| Red meat and processed meat generate carcinogens in the processing method or when we digest them. Consumption was associated with a greater risk of colorectal cancer and lung cancer up to 20%. | Have a balanced diet, follow the recommendations of the food pyramid to ensure adequate nutrition intake: · Consume appropriate amount of red meat (350-500 grams per week). Avoid processed meat and foods containing nitrosamines (such as pickled food). · Eat at least 400 grams of fruits and vegetables daily (equivalent to about 5 servings). · Consuming wholegrains and foods rich in dietary fiber can reduce the risk of colon cancer. |
Sedentary/ Lack of exercise
| Sedentary behavior increases the risk of endometrial cancer, colorectal cancer, breast cancer, and prostate cancer. The most sedentary individuals had an 82% higher risk of cancer mortality compared to the least sedentary individuals. | Minimizing sedentary activities, engaging in regular physical exercise, and keeping a healthy weight can enhance the immune system, support digestive health, lower inflammation, and regulate estrogen and insulin levels. Adults: Engage in at least 150 minutes of moderate-intensity aerobic physical activity or at least 75 minutes of vigorous-intensity aerobic physical activity per week. Children and Adolescents: Engage in at least 60 minutes of moderate to vigorous-intensity physical activity daily to prevent and manage obesity starting early in life. |
Overweight/ obese | An estimated 5% of cancer cases obese in men and 10% in women are caused by being overweight. |
This survey revealed many misconceptions about early-onset cancer. Dr. Lam clarifies that increased sun exposure, intermittent fasting, strict vegetarianism, nutritional supplements, and reduced air travel are not effective prevention measures. "Early-onset cancer prevention should start with diet and lifestyle changes as early as possible. While these changes may appear conventional, they are effective. Don't assume it takes a decade to mainfest - a study shows that just one year of exercise can reduce the risk of breast cancer. Additionally, high-risk individuals with a family history should undergo regular cancer screenings. Beyond family history, many are unaware that high-risk groups for cervical cancer include women aged 21-24 with sexual experience, persistent HPV infection, early sexual activity/multiple sexual partners, or smoking · these individuals should receive regular cervical cytology tests."
Dr. Lam adds that some cancers with more early-onset cases, such as triple-negative breast cancer, progress rapidly with poor prognosis. Patients might need more intensive treatment and face heightened risks of recurrence and chronic illnesses. Young patients often encounter multiple challenges, including the burden of treatment and financial strains. As cancer no longer solely affects the elderly population, HKACS calls for cross-sectoral- collaboration in education, prevention, medical assistance, and policy-making to combat early-onset cancer. HKACS offers comprehensive support for cancer patients of all ages and their families, including free cancer support programmes, cancer risk assessments, and educational booklets. For more information, please visit www.hkacs.org.hk
