Cancer is getting younger: Alarming patterns of early-onset malignancies in Vietnam

Introduction

Cancer was once seen as a disease of old people, but global trends now show a surprising “youngening” of the disease. The number of cancers occurring before age 50 has increased steadily over the last thirty years. Especially in Asia, where almost 60 % of the world’s people live - growing rates of bowel, breast, and stomach cancers among younger adults have become a worrying trend. This change brings significant health and financial problems because patients are often of working age, which leads to a loss of productivity and lasting economic burden [1], [2]. This article serves as a correspondence to highlight the urgency of this pattern in Vietnam and to specifically address the current national cancer policies and their alignment with the growing burden of early-onset malignancies.

Section snippets

Global trends

According to global estimates published in The Lancet Oncology, approximately 1.3 million incident cancer cases and over 377,000 cancer-related deaths occurred among adolescents and young adults (aged 15–39 years) in 2022, underscoring the substantial and often underrecognized oncologic burden in this age group [3]. Recent epidemiological analyses based on high-quality population-based cancer registry data indicate that the age-standardised incidence rate (ASR) of early-onset colorectal cancer...

The Vietnamese context

In Vietnam, the cancer burden has grown rapidly. According to GLOBOCAN 2020, over 182,000 new cancer cases and 122,000 deaths were reported, ranking Vietnam fifth in Southeast Asia [5]. A recent cross-sectional study of 1696 Vietnamese patients aged 18–49 who underwent colonoscopy in Ho Chi Minh City found that colorectal neoplasia occurred in approximately 13 % and advanced neoplasia in 3.7 % of cases. At the same time, breast cancer incidence in Hanoi increased from an age-standardized rate...

Possible causes

The rise in cases of early cancers is likely due to many linked factors.

• Inherited traits: Conditions like Lynch, BRCA, and APC changes are closely linked to early colorectal and breast cancer [1].
• Environmental and lifestyle factors: Poor air quality, consumption of ultra-processed foods, smoking, alcohol, and obesity are important contributors. Many urban areas in Vietnam exceed safe PM 2–5 levels [9].
• Chronic stress and circadian rhythm disruption have been increasingly recognized as...

Challenges in detection and care

Vietnam continues to face challenges in detecting and treating cancer as the country develops:

• There are no national screening programs for colorectal, gastric, and liver cancers.
• Genetic and advanced molecular testing is cost-prohibitive for the majority.
• There is a lack of public awareness, especially among younger people, who may overlook or be indifferent to the early signs of the disease.
• Cancer is diagnosed at a late stage (more than 70 % of cases are diagnosed at stages III-IV), which

Call to action

A comprehensive national strategy addressing early-onset cancers is urgently required, focusing on public health education for people aged 20–40 and the establishment of a nationwide, age-stratified cancer registry, integrating it with GLOBOCAN and hospital systems, among others, to develop capacity for genetic and microbiome screening in major centers. Research support on the biological mechanisms of early-onset cancers in Vietnam should be integrated into this issue in the national preventive...

Conclusion

In Vietnam, the increasing number of cancer cases in younger individuals is a worrying reality. The illness is no longer confined to the elderly but is affecting younger people, who are in their prime working years. Early recognition is needed, along with steps such as screenings and public awareness campaigns. This correspondence article urges immediate policy action based on the growing evidence and available country-level data. With the growth of precision medicine and genetic technologies,...

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors....

CRediT authorship contribution statement

Nguyen Tien Huy: Conceptualization, Project administration, Supervision, Writing – review & editing. Bui Dan Hieu Phuong: Writing – original draft. Nguyen Thien Quang: Writing – original draft. Nguyen Le My Han: Writing – original draft. Truong Ngoc Tham: Conceptualization, Writing – original draft. Phillip Tran: Conceptualization, Project administration, Supervision, Writing – review & editing. Nguyen Thao Ngan: Writing – original draft...

Declaration of Competing Interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed