Colonoscopy is the gold standard for evaluating pathologies of the large bowel, including screening for colorectal cancer. The technological features of current colonoscopes have not progressed much in recent years except for improved image and video display. The technique requires intubation and insufflation of the colon which are operator-dependent and involve a learning curve. Colonoscopy is an invasive procedure whose overall risk of complications is approximately 0.3%, increasing to 2% when polypectomy is performed. The PillCam Colon capsule endoscope (Given Imaging Ltd., Yoqneam, Israel) was developed for use as a safe, minimally invasive, non-sedation requiring, patient-friendly modality to visualize the colon. Only the interpretation of findings requires expertise. PillCam capsule endoscopy could be an alternative approach to colonoscopy for screening large populations. We report the first clinical investigations of the safety, feasibility and performance of colon capsule endoscopy compared with standard colonoscopy.