A leading internal medicine specialist has sounded the alarm on the “alarming rise” of colon cancer in Generation Z and Millennials, urging young people to look out for five critical warning signs as diagnoses soar worldwide. Dr. Zion Ko Lamm, whose insights have attracted nearly a million followers on social media, emphasizes that colon cancer is not just an “old person’s disease”—incidence among the under-50s has jumped by 80% over the past thirty years, even as rates in older adults have declined or stabilised. This alarming trend, detailed in a recent article by the Daily Mail (source), raises urgent questions for Thai healthcare and society, where rapid lifestyle changes could echo Western patterns.
The detection of colon cancer is often delayed in younger people, in part due to a widespread misconception that it only affects older adults. Thai readers may be accustomed to screening campaigns targeting elders, but Dr. Lamm’s guidance makes it clear: “Rates are rising in young adults. Colon cancer doesn’t just happen to ‘old people’.” Major studies reviewed on NPR and in the medical literature (NPR, PubMed study 1, study 2) confirm that early onset cases are not only more common, but frequently more aggressive, with a corresponding increase in advanced diagnoses.
The five key warning signs, as outlined by Dr. Lamm and corroborated by authoritative health sources such as the CDC and Mayo Clinic, are:
Persistent Abdominal Pain or Bloating Continuous or worsening discomfort in the abdomen—whether it’s bloating, feelings of fullness, or crampy pain—explained Dr. Lamm, should not be ignored, especially if it persists for more than four weeks. This pain may become particularly noticeable after meals or may remain localized in one spot, a warning that many young Thais accustomed to spicy or high-fiber diets might misattribute to less serious causes.
Unintentional Weight Loss Losing weight without trying is always a red flag, especially when coupled with other symptoms. Cancer cells and the body’s response can accelerate metabolism and increase calorie consumption even at rest, leading to both muscle and fat loss. Such changes should prompt urgent medical consultation, as highlighted by the experiences of international patients whose stories mirror those increasingly heard in Thai hospitals.
Blood in the Stool Blood in the stool is never normal. Sometimes visible as bright red or dark, tarry black streaks, and sometimes microscopic, this symptom is a red alert. While other common conditions like hemorrhoids or fissures can also cause rectal bleeding, Dr. Lamm and additional medical experts interviewed by NPR (NPR) insist on medical evaluation for anyone noting this sign, no matter their age.
Unexplained Iron Deficiency Anemia Chronic bleeding from colon tumors can lead to iron deficiency. Fatigue, rapid heartbeat, dizziness, weakness—all can result from a body starved of red blood cells and oxygenation, sometimes even before blood is apparent in the stool. Thai doctors warn that people, especially women, may dismiss tiredness as a normal part of busy urban life or active rural work, potentially missing crucial early warning signs.
Changes in Bowel Habits Persistent changes in stool—such as looser, harder, pencil-thin, or narrower stools, or new urgency and pressure—can be an early indicator of blockage or tumor formation. Dr. Lamm is adamant: “Don’t be afraid to talk about your poop, or look at your poop. We all should.” In Thai culture, discussing bowel movements may be considered embarrassing, but these conversations could save lives.
The urgency of Dr. Lamm’s message is amplified by high-profile cases of young, seemingly healthy individuals succumbing to late diagnosis. Stories such as that of Zu Rafalat, a 39-year-old globetrotter who died from late-stage colon cancer after misdiagnoses and delayed medical imaging, echo the need for awareness in Thailand, where busy lifestyles and reluctance to seek medical help can result in similar tragedies.
Globally, the increasing prevalence of colon cancer in young adults is attributed to a combination of genetic factors, unhealthy dietary patterns, sedentary lifestyles, and rising obesity rates. In Thailand, changing food culture—more processed foods, lower physical activity, and increased stress—mirrors these Western risk factors. The Thai Ministry of Public Health has already raised concerns about the growing burden of non-communicable diseases (NCDs), including colorectal cancer, linking them to these lifestyle shifts (Thai Ministry of Public Health Data).
Compounding the problem, Thai screening guidelines for colon cancer still focus on people aged 50 and above, while those at risk under 50 may be overlooked entirely. Dr. Pichai Watcharawipas, an oncologist at a leading Bangkok hospital, told the Bangkok Post, “We need to update our protocols. Early detection—regardless of age—will be critical as Thai eating habits and obesity rates change.” He emphasized that recent international guidelines, including those from the American Cancer Society, now recommend screening as early as 45 for average-risk adults, with even earlier surveillance for those with a family history (American Cancer Society).
Historically, colon cancer was associated in Thailand with older generations and rural populations, possibly due to dietary patterns and lower rates of screening. However, the shift towards a more urbanized, fast-paced society, higher consumption of processed meats, and increasingly sedentary working conditions among Thais under 40 have coincided with patterns seen in Western studies (Exact Sciences). Studies suggest that genetics only account for a portion of the risk, while environmental and behavioral factors are major contributors—a sobering realization for Thai families who may have little history of the disease.
Looking ahead, the trend has serious implications for both Thai health systems and younger generations’ quality of life. Late-stage diagnosis is linked to poorer survival, greater long-term healthcare costs, and often devastating effects on family life and productivity. As Dr. Lamm and multiple reports in the medical literature stress, the earlier the cancer is detected, the better the outcome—five-year survival rates for early-stage colon cancer can exceed 90%, but drop dramatically when caught late (CDC).
So what should Thai readers do? First, everyone—regardless of age—should see a doctor promptly if experiencing any of the five warning signs, especially if they persist for more than a few weeks. Secondly, individuals with a family history of colorectal cancer should speak with their healthcare provider about beginning screening before age 50, and even as early as 40 or younger if at very high risk. Thirdly, maintaining a diet high in fiber (such as fresh vegetables, fruit, and whole grains), exercising regularly, reducing processed foods and red meats, and limiting alcohol and smoking are all proven ways to lower colon cancer risk, as outlined by both Thai and international guidelines (Mayo Clinic).
Most importantly, the stigma around digestive health needs to be broken in Thai culture. As Dr. Lamm insists: “It’s not dirty or embarrassing to talk about your poop. It’s a part of life and can be the first sign that something is wrong. Don’t wait until it’s too late.”
In summary, with colon cancer striking younger generations at unprecedented rates, Thai society must rapidly adapt its approach to education, screening, and risk factor management. Awareness, openness, and proactive health-seeking behavior are the best defences against a potentially deadly but highly preventable disease.
Sources:
- Daily Mail: Leading doctor reveals five key signs of colon cancer
- NPR: Colorectal cancer is rising among Gen X, Y, and Z: Here are 5 key signs
- Exact Sciences: Colorectal cancer in young people
- American Cancer Society: Colorectal Cancer Screening Tests
- Mayo Clinic: Colon cancer – Diagnosis and Treatment
- Thai Ministry of Public Health