Testing for colon cancer screening is important because it can actually prevent some colon cancers or find it early when it is easier to treat. The American Cancer Society recommends colon cancer testing (there are several acceptable methods) for everyone starting at age 50, though some people with certain risk factors may need to start at a younger age. Colonoscopy is one of the most widely used tests because not only can it find colon cancer, it can also find polyps that can be removed before they turn into cancer. Knowing what to expect can take away some of the fear of a colonoscopy and the preparation required for it, often called bowel prep). So here’s 7 things to know before you go.

1. What is a colonoscopy?
A colonoscopy is an exam that lets a doctor closely look at the inside of the entire colon and rectum to find polyps or signs of cancer. Polyps are small growths that over time can become cancer. The doctor uses a flexible hollow, lighted tube about the thickness of a finger that has a tiny video camera on the end. This tube, called a colonoscope, is gently eased inside the colon and sends pictures to a TV screen. Special instruments can be passed through the colonoscope to remove small polyps or take tissue samples if needed.

2. What is a bowel prep?
Bowel prep is a process to clean out the colon as much as possible so the doctor can see the inside clearly and get good pictures. The prep may include eating a special diet, drinking up to a gallon of a liquid laxative, medicines, and sometimes enemas that make you go to the bathroom a lot. You may also be instructed to stop taking certain over-the-counter or prescription medications as long as a week before the test.

3. Where are colonoscopies done?
Colonoscopies may be done in a doctor’s office, a hospital, a clinic, or a surgery center. The tests are typically done in a private room.

4. What to expect
The colonoscopy itself takes about 30 minutes. Patients are usually given medicine to help them relax and sleep while it’s done. If so, you will not be allowed to drive afterward, so someone you know must come with you and drive you home. You’ll also have to plan to stay home for the remainder of the day, until the drugs wear off.

5. Does it hurt?
Most people don’t feel pain during any of the tests, but may feel cramping or discomfort afterward because of air that was puffed into the colon during the test. This is done, to keep it open for the doctor to examine.

6. What if they find something?
If a small polyp is found during a colonoscopy, your doctor will probably remove it during the test. If a polyp is too large to be removed, or if you have something that looks like cancer, the doctor will take a small piece of it out to check it for cancer or pre-cancer cells (a biopsy). The results of this tissue biopsy will determine whether you need other procedures or treatment.

7. How often is a colonoscopy needed?
If nothing is found, you can go up to 10 years without another one. If something is found, you may need more frequent tests or treatment.

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