Cancer is a significant public health problem in South Africa, affecting people of all ages, genders, races, and socioeconomic backgrounds. According to the 2019 National Cancer Registry (NCR), there were 108,168 new cases of invasive cancer diagnosed in the country, of which 51,059 were in males¹. However, the burden of cancer is not equally distributed among different age groups. In this essay, I will focus on the most prominent cancers among men under 40 in South Africa based on the available data and literature.

Data Sources and Limitations

The primary source of data for this essay is the NCR, which is a pathology-based cancer registry that collects information on both solid and haematological cancers diagnosed by histology, cytology, and bone marrow¹. The NCR is affiliated with the African Cancer Registry Network (ACRN) and is recognised by the International Agency for Research in Cancer (IARC)¹. The NCR publishes annual reports on the incidence and distribution of cancer in South Africa, which are used for research, education, and policy-making purposes.

However, the NCR has some limitations that need to be acknowledged. First, the NCR is not a population-based registry, which means that it does not capture all the cases of cancer that occur in the country, especially those that are diagnosed clinically or radiologically or those that are not reported by the laboratories¹. Second, the NCR does not provide data on the mortality, survival, or stage of cancer, which are important indicators of the impact and outcome of cancer¹. Third, the NCR does not provide data on the risk factors, screening, prevention, or treatment of cancer, which are essential for understanding the causes and interventions of cancer¹. Therefore, the NCR data should be interpreted cautiously and supplemented with other sources of information, such as population-based registries, vital statistics, surveys, and studies.

The Most Prominent Cancers Among Men Under 40 in South Africa

According to the NCR 2019 report, the most prominent cancers among men under 40 in South Africa were:

  • Non-Hodgkin’s lymphoma (NHL): This was the most common cancer among men under 40, with 1,082 cases and an age-standardised incidence rate (ASIR) of 10.8 per 100,000¹. NHL is a type of cancer originating from the lymphocytes, white blood cells that are part of the immune system². NHL can affect any body part, but it usually involves the lymph nodes, spleen, bone marrow, or other organs². The symptoms of NHL may include swollen lymph nodes, fever, night sweats, weight loss, fatigue, or infections². The causes of NHL are poorly understood, but factors that may increase the risk include genetic mutations, viral infections, immune deficiency, autoimmune diseases, or exposure to certain chemicals². The treatment of NHL depends on the type, stage, and aggressiveness of the disease and may include chemotherapy, radiation therapy, immunotherapy, targeted therapy, or stem cell transplant².
  • Testicular cancer: This was the second most common cancer among men under 40, with 1,016 cases and an ASIR of 10.2 per 100,000¹. Testicular cancer is a type of cancer that originates from the testicles, which are the male reproductive organs that produce sperm and hormones³. Testicular cancer can affect one or both testicles, and it usually occurs in young or middle-aged men³. The symptoms of testicular cancer may include a painless lump, swelling, or discomfort in the testicle, a change in the size or shape of the testicle, a feeling of heaviness in the scrotum, or a dull ache in the lower abdomen or groin³. The causes of testicular cancer are not well known, but some factors that may increase the risk include undescended testicles, family history, genetic syndromes, or exposure to certain chemicals³. The treatment of testicular cancer depends on the type, stage, and extent of the disease and may include surgery, chemotherapy, radiation therapy, or surveillance³.
  • Leukaemia: This was the third most common cancer among men under 40, with 755 cases and an ASIR of 7.6 per 100,000¹. Leukaemia is a type of cancer originating from the blood-forming cells in the bone marrow, which produce red blood cells, white blood cells, and platelets. Leukaemia can affect any of these cells, but it usually involves the white blood cells, which are responsible for fighting infections. Leukaemia can cause the bone marrow to produce abnormal or immature cells, which crowd out the normal cells and interfere with their functions. The symptoms of leukaemia may include anaemia, bleeding, bruising, infections, fever, night sweats, weight loss, fatigue, or bone pain. The causes of leukaemia are unclear, but some factors that may increase the risk include genetic mutations, viral infections, radiation exposure, or certain chemicals. The treatment of leukaemia depends on the type, stage, and severity of the disease and may include chemotherapy, radiation therapy, immunotherapy, targeted therapy, or stem cell transplant.

Conclusion

In conclusion, the most prominent cancers among men under 40 in South Africa were non-Hodgkin’s lymphoma, testicular cancer, and leukaemia, according to the NCR 2019 report. These cancers have different characteristics, symptoms, causes, and treatments, and they pose significant challenges to the health system and society. Therefore, it is important to raise awareness, promote prevention, facilitate early detection, and improve access to quality care for these cancers, as well as to support research and advocacy efforts to reduce the burden and improve the outcome.

(1) Cancer Statistics – CANSA – The Cancer Association of South Africa. https://cansa.org.za/south-african-cancer-statistics/.

(2) Men & Cancer – CANSA – The Cancer Association of South Africa. https://cansa.org.za/mens-health/.

(3) South Africa – IARC. https://gco.iarc.fr/today/data/factsheets/populations/710-south-africa-fact-sheets.pdf.