Quick Take
Gen Z is facing a rise in colorectal cancer, yet many young people with symptoms delay screening out of fear or embarrassment. UC Santa Cruz literature and psychology student Kathleen Whilden wants to end the embarrassment and writes that yes, getting a colonoscopy is uncomfortable, but it’s far less frightening than a late diagnosis. She knows. She has had several colonoscopies and lived to tell about them – she even has some souvenirs. She pushes her peers to lose their fear of potty jokes and get tested.
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I sat on the toilet for two hours the morning before my first colonoscopy with a sense of dread and relief. I had woken up at 4 a.m. to down the final 48 ounces of prescribed laxatives before my noon procedure.
It’s as uncomfortable and horrifying as it sounds.
I was 23 and not ready to face the idea that I could be sick. That I could have something as scary as colorectal cancer, a disease that is increasingly affecting young adults like me.
If you are around my age and having any sort of gastrointestinal issues, you might need to be screened for cancer with a colonoscopy soon, too.
The National Cancer Institute reports that as of 2023, colorectal cancer was the leading cause of cancer deaths in people aged 20 to 40, though it used to be considered a disease that affects the elderly. Yale Medicine studies also warn of the alarming rise. Actor Chadwick Boseman, the star of “Black Panther,” brought colorectal cancer into public discourse in 2020, when he died at 43. And in February, “Dawson’s Creek” star James Van Der Beek died at 48, after a 2½-year battle.
Both deaths were shocking – and a pressing reminder that the recommended screening age for this cancer has dropped from 50 to 45, and as early as 20 if you have a family history of colon polyps, symptoms or other risk factors.
The reason it’s so fatal for young people is that they are diagnosed at later stages and screened less often.
I got my first colonoscopy in June 2025, right after I told my doctor I had abdominal pain and constipation. She told me the best way to test for a variety of illnesses, including celiac disease and inflammatory bowel disease, was to take tissue samples directly from my large intestine. The steps of the procedure were simple: I would clean out my colon with laxatives until my stool ran clear, and then she would insert a small tube called an endoscope through my anus to collect samples and images.
It sounds scarier than it feels.
The nurses gave me warm blankets and everyone was kind. The hardest part was coming face to face with my own mortality as the last of my morphine drip ran dry. I fell asleep afraid of what my doctor would tell me. I was scared of dying.
My doctor found a 38-millimeter sessile serrated adenoma in my colon. This type of polyp growth is precancerous and benign. I needed two more colonoscopies that year to remove it.
One in 24 people will be diagnosed with colorectal cancer in their life. I got lucky that mine was spotted and removed early. I would prefer to be alive, even with the hours of diarrhea and the red imprints of a toilet seat on the backs of my thighs and a raw butthole.
In Santa Cruz County, the numbers are high – 36.6 cases per 100,000 residents (2017-21), which is higher than both the California (33.5) and U.S. (36.7) averages. The numbers also put Santa Cruz County in the worst quartile statewide. Local, age-specific data is limited, so it makes it hard to pinpoint how many young people here are affected. But it’s not a stretch to believe we match the national pattern.
The experience – the fear and the diagnosis – humbled me. It also grounded me. It might sound dramatic, but with a Big Gulp of magnesium citrate and Sprite on the bathroom counter next to me, all I could do on that toilet was breathe and stay present. It brought me closer to my body than any yoga studio could.
I’ve struggled with depression for years, and whether I was stretched into downward dog or in tree pose, taking deep breaths of jasmine incense, I was always distracted. Even when I would try to set a timer on my phone in various meditation apps, I couldn’t get a break from my thoughts.
Bowel prep (the prescribed course of laxatives), it turns out, is grounding in a way meditation never was.
Yes, it can be nerve-racking to bring up butt stuff with your doctor.
It’s embarrassing to talk about bowel movements. Laxatives and a tube up your butt sound intimidating. On average, it’s about 2 liters of laxatives in the 24 hours before a routine procedure.
My friends were horrified when I described it and cringed every time I mentioned it. My family winced when I asked them about their colonoscopies and what to expect for mine, despite the hereditary risks of colon polyps I carry. One family member told me they wished they could bury their head in the sand and never think of this again.
My response? It’s just poop. Almost everyone will get at least one colonoscopy in their life.
In preparation for my third colonoscopy last year, I wanted to avoid the awkwardness and stay in a motel room instead of my sister’s apartment. I didn’t want her to hear me in the bathroom. But I was nervous to be alone before the procedure and I ended up taking one of my laxative doses in her bathroom. I wasn’t embarrassed by the diarrhea anymore. She let me sleep on her couch. Turned out, I needed her support more than I needed privacy and modesty.
Colorectal cancers are treatable, but they are almost impossible to detect in the early stages without these screenings. The father of a dear friend of mine passed away from colon cancer. He was 11 when his father received his diagnosis. By the time his father had gone to his doctor with his symptoms, the cancer had already progressed to Stage 4.
It’s a personal decision, one I hope you pause to consider.
It might sound gross, like it wouldn’t happen to you, but talk to your families. Did your parents have colon polyps? Any relatives with colorectal cancer? Find out their histories. Your doctor might recommend this screening to you soon. Allow that time to process your mortality and embrace the messy realities of caring for your body.
Be proactive. The upsides are immense.
And there is this: I now have 12 color photos of the inside of my butt.
Kathleen Whilden is a senior literature and psychology major at UC Santa Cruz. She takes inspiration from her grandmother to tell honest stories of our bodies and medical experiences. She wrote this piece as part of Community Voices editor Jody K. Biehl’s UCSC opinion writing class.