Colonoscopies help prevent colorectal cancer by finding precancerous lesions and removing them before they have an opportunity to develop into cancer. However, many people — perhaps even you — are anxious or fearful before a medical procedure, especially if you’re worried your doctor may find cancer.

Dr. James Church, a colorectal surgeon at Cleveland Clinic, noticed that many of his patients were very anxious before undergoing a colonoscopy. He wanted to understand how much their anxiety affected their clinical and emotional experience and what health care professionals might do to relieve some of this anxiety. So, he surveyed 119 patients in his practice (11 were undergoing their first colonoscopy) and presented his findings at the American Society of Colon and Rectal Surgeons Annual Scientific Meeting. Church found that those patients who reported higher levels of fear and anxiety also said they experienced significantly more pain during their colonoscopy.

[See: 6 Options for People Who Don’t Want a Colonoscopy.]

Embarrassment and not having enough knowledge about the procedure are two factors that cause anxiety around colonoscopies, says Dr. Deepak Agrawal, a gastroenterologist and an associate professor with the UT Southwestern Medical Center Department of Internal Medicine. “Embarrassment is probably more cultural,” he says. Certain communities, such as Asian or Indian populations, for example, are less likely to undergo colonoscopies.

Other major sources of anxiety are fear of what the doctor might find and of having pain or discomfort during the procedure. Of course, Church says, a certain degree of nervousness is normal. However, some people are extremely anxious, and this may lead to a bad experience.

Anxiety Leads to Increased Sedation Needs

One reason experts like Church and Agrawal are concerned about patient anxiety is because it directly affects sedation. “When people are more anxious, they’re more likely to need more sedatives or not be as well sedated during the procedure,” Agrawal says. “They may wind up using higher doses of medications. If they’re anxious, it’s difficult to sedate them quickly, and they may not have a good experience.”

Many colonoscopies are now being performed under deeper anesthesia using a sedative called propofol, Agrawal says. But he adds that the practice is controversial because an anesthesiologist must administer propofol, whereas a gastroenterologist can administer light sedation. Agrawal says having an anesthesiologist can add another $600 to $700 to the cost of a colonoscopy, a cost not all insurance companies cover. This potential increased out-of-pocket cost can also exacerbate someone’s anxiety about the procedure.

Church says he generally starts with a small dose of a sedative agent and, if he sees a patient is very anxious, gradually increases the dose if necessary. He prefers to have patients consciously sedated so they remain arousable. He says a cooperative patient is helpful. He or she can change position if needed, for example, which can sometimes facilitate a smoother colonoscopy.

[See: 8 Questions to Ask Your Doctor About Colon Cancer.]

Reducing Anxiety Before Colonoscopy

Patients need more information about colonoscopy to help ease their anxiety and put their fears to rest, Agrawal says. “If a patient isn’t well informed about the procedure before they show up, their anxiety level is higher.” Unfortunately, Agrawal says, health care providers don’t do a stellar job of providing good information ahead of time, and much of the material on the internet is inadequate in addressing the major causes of patients’ anxiety.

Agrawal says the top questions patients have are: “What are the chances you’ll find something bad?” and “What do you do if you find something?”

“I tell them there’s a 25 percent chance I’ll find a polyp and, in most cases, I’m able to remove it.” Furthermore, Agrawal says, “Just because you have polyps doesn’t mean you have cancer. Very few polyps actually have precancerous lesions. That’s why I’m removing them, before they have a chance to turn into cancer. A pathologist looks at all polyps under the microscope. If a polyp is precancerous, you need to come back [for another colonoscopy] in three to five years, depending on the size of the polyp and the number of polyps we find. If your colonoscopy is clear, you don’t need to come back for 10 years.”

He adds: “Quite often, the first interaction between a patient and gastroenterologist is on the day of the procedure. This is OK for some patients because colonoscopies are a fairly common procedure and there’s a lot of information on the internet.” But for others, that’s not ideal. “They want to know who’s doing the procedure,” Agrawal says. “They have a lot of questions about it. Patients are given an opportunity [to ask questions] before [we begin], but I think by that time, it may be too late. They’re already anxious about the procedure.”

Church cautions people not to let others’ experiences drive their own pre-colonoscopy jitters. “Everyone’s colon is different,” he says. Unfortunately, some colons have an anatomy that’s less favorable to colonoscopy. The technique, the amount of sedation required and the experience of pain all vary among patients. “It’s a mistake to apply someone else’s experience to your own,” Church says.

[See: What to Eat, Drink and Do to Relieve Constipation.]

If you’ve scheduled a colonoscopy, request information beforehand and don’t hesitate to ask your health care provider questions, especially if you’re feeling anxious. If you like to find information online, Agrawal says the American Society for Gastrointestinal Endoscopy and American Gastroenterological Association offer detailed information about colonoscopies.

More from U.S. News

6 Options for People Who Don’t Want a Colonoscopy

8 Questions to Ask Your Doctor About Colon Cancer

What to Eat, Drink and Do to Relieve Constipation

What to Do About Pre-Colonoscopy Anxiety originally appeared on usnews.com