A new report from the American Cancer Society (ACS) reveals a worrying trend: while cancer deaths have dropped by 34% in the U.S. over the past three decades, new cancer cases are rising among younger people, particularly in women. This alarming trend raises urgent questions: Are we seeing the same pattern in Malaysia? And more importantly, are we doing enough to prevent a growing health crisis among the next generation?

More younger people are getting cancer, but women are at higher risk in some age groups

According to the ACS report, women aged 50 to 64 are now more likely to develop cancer than men in that same age group. Even more concerning, women under 50 are now 82% more likely to be diagnosed with cancer than men, a dramatic rise from 51% in 2002.

This shift marks a critical turning point in cancer trends—one that demands urgent attention and action. Historically, men had higher cancer rates, partly due to higher smoking rates and occupational exposures. But today, we see shifting lifestyle risks and gaps in prevention strategies that could be driving up cancer rates among women.

What is even more worrying is that many of these risk factors are within our control, yet we continue to underestimate their impact.

Why is cancer rising among younger people?

While aging remains the strongest risk factor, the rise in cases among younger people suggests that lifestyle, environmental, and biological factors are also at play. The U.S. is seeing this troubling trend, Malaysia, with its own unique health challenges, may be facing similar issues. The question is, “Are we on the same path?” If so, can we take proactive steps before the situation worsens?

1. Obesity and physical inactivity are major risk factors

Malaysia has one of the highest obesity rates in Southeast Asia, where 50% of adults are either overweight or obese. Excess body fat is not just a cosmetic issue; it increases the risk of breast, colorectal, endometrial, and other cancers.

How does obesity cause cancer? Fat tissue produces excess estrogen, which increases the risk of hormone-sensitive cancers like breast and endometrial cancer. Physical inactivity is also a problem. Malaysians are among the least physically active populations in Asia. Lack of exercise is linked to higher cancer risk and poorer survival rates. Sedentary work culture in urban areas contributes to inactivity, as many jobs require prolonged sitting with little opportunity for movement.

2. Smoking and vaping trends are worrisome

The ACS report noted that lung cancer rates in women under 65 have now exceeded those in men, even though men historically smoked more. While smoking rates among Malaysian men have declined, smoking and vaping are rising among young women.

Vaping is not harmless. While marketed as a “safer alternative” to smoking, the long-term risks remain unknown, and early studies suggest it could still contribute to lung and other cancers. A sobering example from neighbouring Thailand : A 12-year-old girl suffered near-total lung damage after just two years of vaping, underscoring the severe health risks e-cigarettes pose, especially to young users.

Although Malaysia has regulations to curb the marketing of vaping products to minors, enforcement gaps and targeted marketing through flavoured products, online ads, and social media continue to make these products easily accessible to young  including women. The exemption of nicotine from the Poisons Act in March 2023 has led to the unregulated sale of nicotine-containing e-cigarettes, further complicating efforts to protect vulnerable groups. The Global Adult Tobacco Survey 2023 shows e-cigarette use among people aged 15 to 24 has surged from 1.1% in 2011 to 8.6% in 2023.

If this trend continues, we risk facing a tobacco and nicotine-related health crisis including rising cancer cases, that we are simply not prepared for.

3. Even small amounts of alcohol increase cancer risk, especially for women

Alcohol is directly linked to at least seven types of cancer including breast, colorectal, and liver cancer.

Heavy drinking (more than two alcoholic drinks per day) is responsible for most alcohol-related cancer cases, but light to moderate drinking (up to two alcoholic drinks per day) is not risk-free either. In fact, about 1 in 7 alcohol-related cancer cases are linked to moderate drinking.

Many people assume that a glass of wine or a casual drink here and there is harmless but research shows that even small amounts of alcohol can increase cancer risk, especially breast cancer in women due to its effect on estrogen levels. Women are biologically more vulnerable to alcohol’s effects. The body processes alcohol differently based on sex, meaning women have a much lower threshold before it raises cancer risk.

Yet, awareness about this link remains low. How often do we see public health campaigns actively warning Malaysians about this risk?

4. The role of environmental and systemic factors

Cancer is not just about personal choices; it is also shaped by the environments we live in.

Air pollution is a significant but under-recognized cancer risk. Breathing in polluted air over time can silently harm your health. Studies show that just a small increase in air pollution, similar to what you might experience on a hazy day in a city can raise your risk of lung cancer by about 9%. This means that long-term exposure, even at levels commonly seen in Malaysian cities, could significantly impact cancer rates.

Food environments encourage unhealthy eating. Ultra-processed foods, fast food, and sugar-laden beverages dominate Malaysian diets, contributing to obesity and metabolic disorders linked to cancer. Weak restrictions on the marketing of ultra-processed foods and fast food, particularly those high in sugar, fat, and salt, allow aggressive advertising targeting youth and lower-income groups.

Without stronger regulations, are we setting ourselves up for a public health disaster?

Conclusion

The rise in cancer cases among younger people, especially among women is a growing concern that cannot be ignored. While lifestyle choices play a role, the reality is that many of these risk factors are shaped by broader societal influences ranging from the accessibility of unhealthy food to aggressive marketing of harmful products like alcohol, vaping devices, and ultra-processed foods. The burden of prevention cannot fall solely on individuals. Without broader, policy-level solutions and community-based actions, the trends seen in the U.S. could become a reality for Malaysia.

The next step is to move beyond individual responsibility and explore the broader solutions needed to drive meaningful cancer prevention in Malaysia. The data is clear, and the warning signs are here. The real question is, will we act before it’s too late?