SA’s most common cancers: how to identify and prevent them

In South Africa, the most common types of cancer are lung, prostate, colorectal, breast, and cervical cancers.

But you can manage these cancers by living healthily and getting screened early, explains Dr Lesiba Mashitisho, a specialist physician at Mediclinic Legae.

Lung cancer

Incidence: Lung cancer is the leading cause of cancer death among both men and women.

Who’s most at risk? Smokers are most at risk as smoke is responsible for most lung cancer cases. Exposure to other carcinogens also increases risk, including second-hand smoke; asbestos; and radon (an odourless, invisible natural gas found in rock and soil that can get into homes and buildings and build up over time). Quitting smoking at any age can significantly lower the risk of developing lung cancer.

Symptoms: Most lung cancers don’t show symptoms until they’ve spread, but some patients with early lung cancer do show symptoms. These may include a persistent cough; coughing up blood or rust-coloured spit; chest pain that’s worse with deep breathing, coughing, or laughing; hoarseness; shortness of breath; feeling tired or weak; infections such as bronchitis and pneumonia that persist; and wheezing. If the cancer has spread to other parts of the body, it can cause bone pain; nervous system issues; jaundice and swollen lymph nodes.

Screening: Early detection through low-dose CT scans is recommended for high-risk individuals, such as heavy smokers and those with a significant smoking history.

Prostate cancer

Incidence: Men in South Africa have a 1 in 15 chance of developing prostate cancer, figures from the Cancer Association of South Africa (CANSA) show.

Who’s most at risk? This type of cancer is especially common among black men. Other major risk factors are a family history of cancer (including breast cancer in a close female relative), and obesity.

Symptoms: The prostate is a small gland that forms part of the male reproductive system. Prostate cancer symptoms don’t appear initially, but as the cancer progresses, the patient generally experiences urination issues, such as a more frequent need to pass urine, coupled with a weak flow and difficulty starting or stopping, and blood in the urine. They may also experience a burning sensation when ejaculating.

Screening: Early detection and successful treatment of the condition are more likely because many prostate cancers are slow growing. Screens include a prostate-specific antigen (PSA) test, which screens for elevated levels of the PSA protein in the blood; as well as a digital rectal exam, where a doctor inserts a gloved finger into the rectum to detect enlargements or lumps in the gland. From age 50, men are advised to have a PSA test every two years and a digital rectal exam annually.

Colorectal cancer

Incidence: Colorectal cancer affects both men and women, but it is more common among men. It affects 1 in 77 males in South Africa, according to CANSA, making it the second most common cancer in this group. It also affects 1 in 132 females in this country.

Who’s most at risk? Those with poor lifestyle habits, e.g., obesity; infrequent exercise; a diet high in fat and low in fresh produce; and excessive alcohol intake. A family history of polyps or colorectal cancer also puts you at risk, as well as having conditions like inflammatory bowel disease (IBS) or type 2 diabetes.

Symptoms: Cancerous cells develop in the colon and rectum (anus), a part of the large intestine. This is usually preceded by the growth of a small mass called a polyp. In the initial stages, colorectal cancer doesn’t show symptoms. However, as the disease progresses, patients may notice that they don’t feel “empty” after going to the toilet and feeling feel weak and fatigued. Unexplained weight loss is a further symptom, along with gastric discomfort like gas and cramping, changes in bowel habits, and blood in the stool.

Screening: Because of the lack of early symptoms, it’s important to have a colonoscopy every 10 years from age 50, particularly if there is a family history of the disease. Colonoscopy is a procedure to check the inside of your colon (large intestine).

Breast cancer

Incidence: Breast cancer is the most common cancer among women in South Africa, with a lifetime risk of 1 in 27, according to CANSA.

Who’s most at risk? Family history is a key risk factor of the development of breast cancer, especially if you have a close female relative, such as your mother or sister, diagnosed with the disease.

Symptoms: Changes in the breast like the shape, size and texture, e.g., red, scaly or pitted skin on the nipple or puckering of the skin. Other key signs include a retracted nipple, swellings around the armpits, or lumps.

Screening: This is vital for all women, and the simplest screen is self-examination: it’s recommended that every woman examine her own breasts once a month, looking out for any of the signs and symptoms above. If you detect one or more of these, schedule a mammogram as soon as possible, for further investigation. All women should go for a mammogram annually from age 40, even if you don’t detect any potential issues yourself.

Cervical cancer

Incidence: Cervical cancer affects the cells of the cervix, an area leading from the uterus to the birth canal. In comparison to global figures, the incidence is even higher in South Africa, where more than 5 000 new cases are diagnosed every year. 

Who’s most at risk: The changes in cervical cells which happen before cervical cancer develops are usually caused by exposure to the human papillomavirus (HPV), a sexually transmitted virus. For this reason, a key step to preventing cervical cancer is delaying sexual activity and practising safe sex. It is also highly recommended that girls are vaccinated against HPV between the ages of 9 to 13.

Symptoms: Cervical cancer is often symptom-free in the early stages. As it advances, women may experience symptoms such as vaginal bleeding between periods or after sex; a heavy and ongoing discharge; painful intercourse; and a need to urinate more frequently. These symptoms can also affect menopausal women.

Screening: Cervical cancer is usually detected through a Pap smear, a test that collects cells from the area. It is recommended that women have a Pap smear every three years between the ages of 21 and 65 regardless of whether you experience any symptoms.

Prevention and early detection of common cancers

Not all cancers are preventable, but awareness of common cancers and their risk factors is the first step towards prevention and early detection. By adopting a healthy lifestyle, avoiding known carcinogens, and undergoing regular screenings, you can significantly reduce your risk of developing cancer or detect it early when it is most treatable.

Visit your doctor to figure out the best ways to screen for and prevent cancer based on your personal risk factors and health history.

To find a physician or oncologist near you, click here.