JOHANNESBURG — Colorectal cancer was once considered a disease of older people. That is changing.
Following the death of Lisa Koppel, wife of singer Danny K, at 41, doctors and awareness groups are urging South Africans to learn the early warning signs of colorectal cancer, which is increasingly affecting younger adults.
The cancer starts in the colon or rectum, often developing from small growths called polyps that can become cancerous over several years.
Screening can detect these changes before they develop into cancer, while early diagnosis can improve treatment options.
Why colorectal cancer is rising in younger adults
For decades, screening guidelines focused on people aged 50 and older because colorectal cancer occurred mainly later in life.
That picture has shifted, with early-onset colorectal cancer increasing among younger adults. Researchers continue to investigate the reasons behind the rise.
Doctors point to several possible risk factors, including obesity, physical inactivity and smoking. However, researchers have not identified one single cause for the increase in younger adults.
Younger patients may also overlook symptoms because they do not expect colorectal cancer at their age. Some symptoms can resemble less serious conditions, which may delay diagnosis.
Colorectal cancer warning signs to watch for
Colorectal cancer can develop without obvious symptoms in its earliest stages. As the disease progresses, however, several warning signs may appear.
These include:
- Blood in the stool or rectal bleeding
- Persistent abdominal pain
- A change in bowel habits
- Diarrhoea
- Unexplained weight loss
- Iron-deficiency anaemia or persistent fatigue
Research into early-onset colorectal cancer found that four warning signs — abdominal pain, rectal bleeding, diarrhoea and iron-deficiency anaemia — were more commonly reported in younger adults later diagnosed with the disease.
These symptoms do not automatically mean someone has cancer. However, persistent or unexplained symptoms should be discussed with a doctor rather than dismissed because of age.
When should colorectal cancer screening start?
Major international health organisations generally recommend that people at average risk start colorectal cancer screening at 45, rather than 50.
Screening can detect colorectal cancer or precancerous growths before symptoms develop.
People with a family history of colorectal cancer, certain inherited conditions such as Lynch syndrome, or inflammatory bowel disease may need to start screening earlier or undergo screening more frequently.
A colonoscopy is one of the most comprehensive screening tests because doctors can examine the colon and remove precancerous polyps during the procedure.
Colorectal cancer information and screening guidance
South Africans looking for information about colorectal cancer, symptoms and screening can contact CANSA on 0800 22 66 22.
CANSA also provides colorectal cancer information and support resources through its website.
Lisa Koppel’s death adds to cancer awareness conversation
Danny K said Lisa had hoped to use her own diagnosis to raise awareness once she recovered, a chance she never got.
He and the wider Koppel and Gundelfinger families are now continuing that message publicly.
It follows a string of South African public figures who have opened up about serious illness in recent years, including Isidingo star Michelle Botes, who died in 2024 after a battle with a rare blood cancer, and football coach Shakes Mashaba, whose family has appealed for support during his prostate cancer treatment.
The message for younger adults is straightforward: do not ignore persistent or unexplained symptoms.
Abdominal pain, rectal bleeding, changes in bowel habits or unexplained anaemia should be assessed by a doctor, particularly when symptoms persist or return.
