Colorectal cancer (CRC) is increasingly being diagnosed among younger individuals in Pakistan, raising alarm within the medical community and the public. Once considered predominantly a disease of older adults, CRC is now significantly affecting patients under the age of 40. This worrying trend underscores the urgent need for greater awareness, early diagnosis and effective treatment.
A study conducted at Aga Khan University Hospital in Karachi has revealed striking data regarding early-onset CRC. Among the CRC patients analysed, 32% were younger than 40, with the average age being just 33 years. Men were twice as likely as women to receive a diagnosis. The study also found that colon cancers accounted for 55% of cases, while rectal cancers constituted the remaining 45%.
Younger patients face unique challenges. Certain aggressive cancer types, such as the signet ring cell type, have been found to be more common in younger patients. This suggests that cancer in younger people might have a different biology than older individuals. There is increasing interest globally in investigating the predisposing factors and biology of early-onset CRC with the aim of identifying high-risk patients and tailoring treatments leveraging precision medicine.
The increasing prevalence of early-onset CRC Pakistan underscores the critical need for heightened awareness. The public must be educated about the warning signs of CRC, such as unexplained changes in bowel habits, rectal bleeding or persistent abdominal discomfort. Screening programmes should not be restricted to older adults. In view of the global trends of early age of diagnosis, the recommended screening for CRC has been revised to begin at 45 years compared to 50 years in the past. Moreover, further research is essential to understand the unique characteristics of CRC in younger patients in Pakistan, which will facilitate the development of more effective treatment options.
CRC’s rising incidence among young adults in Pakistan demands immediate attention. By promoting awareness, improving access to screening and advancing research, we can address this growing health challenge. Early detection and timely treatment have the potential to save lives and improve outcomes for those affected by this complex disease.
Dr Munira Moosajee
AKUH, Karachi
