The 30-Minute Screening That Could Add Years to Your Life

Brooks Bell first noticed something was off while on a work trip when she saw blood in her stool. It was 2018. She was 38 years old. When she got home, she was reassured—by two different doctors—that it was probably hemorrhoids. But her symptoms didn’t go away.

In early January of 2019, Bell finally got a colonoscopy—and it saved her life.

Bell was diagnosed with stage three colon cancer. She began chemotherapy and had 10 inches of colon removed. Today, she’s cancer free. “I had so many questions,” she tells SELF. “How did this happen to me? What causes colon cancer?” But what stood out most for Bell was the power of that quick, 30-minute procedure. So she started to talk about it publicly.

The Today show published a story about her experience. Then she partnered with celebrities like Ryan Reynolds—who released a video of his first colonoscopy—to help raise awareness. The result? Millions of YouTube views, and a sharp spike in colonoscopy appointments in the weeks after the video was released. Soon after, Sarah Beran, a fashion stylist with two young children who was diagnosed with late-stage colon cancer at 34, reached out. The two decided to team up.

Their mission was simple: Rebrand colonoscopies, from a dreaded medical chore, to what it is—a powerful, life-extending intervention. In 2023, they launched Worldclass (emphasis on the “ass”), a foundation aimed at dismantling the idea that colonoscopies are just for older adults and helping to fund the procedure for the uninsured or underinsured including by selling merch that says things like “Colonoscopy Enthusiast.”

“Everyone has a colon,” says Bell. “This thing is happening to younger and younger people, and there’s a solution, but [for younger adults] it’s difficult to get and no one knows about it.”

In the US, colorectal cancer diagnoses are increasing among people under 50. It’s now leading cause of cancer death for people in this age group. One in five diagnoses occur in people under 55—double what it was 30 years ago. The evidence is not just in the science papers and journal articles, it’s in the headlines: Just this year, Dawson’s Creek actor James Van Der Beek died at 48 from the colorectal cancer. In 2020, actor Chadwick Boseman died from the disease at 43.

Researchers are untangling the causes behind the rise in colon cancer in young people, and point to several potential factors including ultraprocessed foods, obesity, genetics, and environmental toxins. If you’re invested in longevity, it’s never been more important to take colonoscopies seriously.

The conversation around extending your health and lifespan has centered on peptides, platelet-rich plasma therapy, full-body MRIs, and ultra-red-light saunas—all of which are darlings of biohackers, despite their lack of proven benefits. Instead, it’s the routine things we’ve known about for years that can actually extend your life—like getting screened for colon cancer.

Colonoscopies are backed by decades of research, and the data is clear: This screening procedure is associated with up to a 69% decrease in new colorectal cancer diagnoses, and a 68% to 88% decrease in death, “which is huge,” Beran tells SELF. “[A colonoscopy is] the difference between getting cancer and not getting cancer. It really matters,” adds Bell.

Colon cancer 101

Most colorectal cancer starts out as a small clusters of cells, or “polyps,” that develop in the lining of your colon. Most polyps—which often develop in your 40s, but can also show up as early as your 20s—aren’t cancerous and don’t cause any symptoms.

“They start as little tiny bumps, like a little pimple, and they grow and grow, but very slowly,” Folasade P. May, MD, a gastroenterologist at UCLA Health tells SELF. “So, it could take 10 years for a polyp to grow into cancer.” The good news is, that means doctors have time to intercept them. The bad news is, it’s hard to know they’re there without a colonoscopy.

“Most people are walking around with polyps and don’t know they have them—no symptoms at all,” Dr. May says. “That’s kind of the most dangerous thing about this disease, is how well and healthy and vibrant and active you can be and be diagnosed with a late-stage disease.” This is especially true of perimenopausal and menopausal women, who might attribute feeling slightly off to menopause instead of colorectal issues, Dr. May adds.

The beauty of a colonoscopy is that it’s not just a preventative check. It’s also a chance for doctors to remove any polyps—benign and pre-cancerous—before they become a bigger problem. “It’s the preventable cancer because an action can be taken in order to prevent that process of it going from pre-cancer to cancer,” Samantha Nazareth, MD, a gastroenterologist, tells SELF.

In that way, colonoscopies sit leagues apart from other screens and tests:. “We can’t say that about mammograms. We can’t say that about lung screening. We can’t say that about PSA [prostate-specific antigen] prostate cancer screening. We can’t say that about even, like a bunch of lifestyle [habits],” says Bell. “This is an unbelievably powerful, 30-minute procedure that you do once a decade.”

The challenge is timing. For years, routine screening began at 50. By 2023, rising colorectal cancer rates in young people became stark enough that the United States Preventive Services Task Force lowered the recommended age for colonoscopy screening to 45.

Dr. Nazareth doesn’t think 45 is early enough. Looking at the current data, “I suspect it’s going to get younger,” she says. Dr. May is in favor of re-running newer data and metrics through the models that help establish reasonable screening ages. (It’s worth noting that the United States Preventive Services Task Force, which is the governing body that runs the data and puts out these guidelines, is in jeopardy under the current Presidential administration, so it’s unclear when or if those models will be re-run).

The procedure is not without its risks. While major complications occur in only 0.003 to 0.01% of cases, there is still a possibility of tearing your colon wall during the procedure, having a reaction to the sedation, infections and bleeding. And even though it’s a relatively safe procedure overall, when you’re talking about millions and millions of people, the number of people affected also increases. “So, you do have to be careful [not] just giving everyone a colonoscopy,” says Dr. May.

The advice is straightforward. If you’re 45, get screened, and don’t delay. If you’re under 45, and have a family history of colorectal cancer or polyps, talk to your doctor. And no matter your age, know what symptoms to look out for: blood in your stool, severe pain in your anus, sudden changes in bowel movements (like new, persistent constipation or diarrhea), iron deficiency, anemia, weight loss, and fatigue. “Go see a gastroenterologist and push for a colonoscopy,” Dr. May says.

Easier said than done, of course, especially for a young person whose doctor may dismiss or minimize concerns due to their age. This is one of the bigger issues in adequate colorectal cancer awareness and care, Michael Sapienza, CEO of the Colorectal Cancer Alliance, tells SELF. In the US, the majority of young people have to be seen by two doctors before they’re taken seriously about colorectal cancer. Some have to see up to four.

Cost and access make things harder. Colonoscopies are typically covered by insurance only after 45 or when symptoms are severe. Specialists aren’t available everywhere. And even among those who are eligible, many avoid screening—because it feels intimidating, inconvenient, or embarrassing. As of 2022, only 61% of adults aged 45 to 75 were up to date on screening.

So while colonoscopies are “the gold standard,” in Dr. Nazareth’s view, for people not at high risk for colorectal cancer, “any test is a good test. It doesn’t matter if it’s [a] colonoscopy.” Cologuard, for example, an FDA-approved fecal test, while not a replacement for a colonoscopy is an effective tool to screen for colon cancer.

Reframing colonoscopies

For a long time, colonoscopies have been the punchline of aging jokes. But most people who’ve had them say the reality isn’t that bad.

The prep is usually the most intimidating: A clear liquid diet the day before your colonoscopy plus drinking several liters of water mixed with powdered medication that clears your bowels. Bell and Beran have lots of little tips that can make it better, like popping the liquid in the fridge to make it cold, proactively using hemorrhoid cream, and booking your colonoscopy after 11 a.m. so you don’t have to take your second dose of prep medication in the middle of the night.

Bell and Beran are also adamant that framing is everything. “It’s like a nice little cleanse. It’s the best nap of your life,” says Beran. Hop on social media and you’ll see plenty of other people saying the same. There are also some advancements in the prep process. For one, you can now take a 12-pill regimen instead of drinking the prep formula that some people find difficult to down. But the pills are not always covered by insurance and can be more expensive out-of-pocket.

Whether you think of it as a spa day, a longevity protocol, or a way to stick around for your loved ones “colon cancer screening will save your life,” says Sapienza, who lost his mom to colorectal cancer on Mother’s Day in 2009. She was 56. “If my mom would have gotten screened, she would be alive.”

Beran is determined to get her kids screened as soon as possible since her cancer occurred at such a young age. Her husband, she tells me, had a colonoscopy scheduled for the next day. “He’s been so excited about it because he knows it’s not such a big deal,” she says.

A clean bill of colon health may be one of the most powerful longevity hacks there is.