MNGI Digestive Health recommends colonoscopy as the best test to prevent colorectal cancer. Colonoscopy is the only test to screen, prevent, detect, treat, and cure significant colon lesions during one exam.
What is Cologuard®?
Cologuard® is a new, noninvasive colon cancer screening test that does not require any preparation or dietary changes. It can be used by men and women 45 years of age and older who are at average risk for colon cancer. It should not be used by those who are at higher risk for colon cancer including those with a history of inflammatory bowel disease or a known family history of colon cancer or precancerous polyps.
How does Cologuard® work?
If cancerous or precancerous tissue is in your colon, those abnormal cells may be picked up by stool as it passes through your colon. Cologuard® is a stool test that uses laboratory technology to find the DNA from these abnormal cells. Cologuard® is not a genetic test; it only looks for altered DNA associated with colon cancer and precancerous cells in the colon.
How is the Cologuard® test performed?
The Cologuard® test is performed by collecting a stool sample at home with a kit that is provided by Cologuard®. This process involves placing a plastic collection bucket on the toilet seat, collecting the stool sample, scraping the sample with a collection probe and placing the remaining stool sample in a liquid solution. The stool sample needs to be shipped to a laboratory for evaluation within 3 days of collection. A physician will review the results of the study and will order additional tests as needed.
All positive Cologuard® results should be followed by a screening colonoscopy. Following a negative result, patients should continue participating in a routine screening program. Cologuard® test should be performed every 3 years.
How does Cologuard® compare to other non-invasive tests?
The fecal immunochemical test, also known as “FIT”, is a noninvasive colorectal cancer screening test that has been around for many years. The FIT test is widely available and is included in all the U.S. colorectal cancer screening guidelines.
In clinical studies, Cologuard® found 92% of colon cancers and 42% of advanced precancerous tissue in the colon; in other words, it missed 8% of colon cancers and it missed almost 60% of the advanced precancerous tissue. It was more sensitive than the FIT test in detecting colorectal cancer however, false positives and false negatives can occur with any test. Cologuard® was positive in 13% of people without cancer as compared to the FIT test with a 5% false-positive rate.
What does Cologuard® cost?
The cost for each Cologuard® test is $599. In comparison, the cost for the FIT test is $25.
Is Cologuard® covered by insurance?
Since Cologuard® is a relatively new test, coverage for this test might vary. Medicare recently stated they would cover the test once every three years for people between ages 50 and 85 who do not have any symptoms.
Who should consider Cologuard®?
- Those patients who refuse a screening colonoscopy AND if the Cologuard is positive would accept a screening colonoscopy or CT colography.
- Those patients with chronic illnesses which raise their individual risk for screening colonoscopy AND have an acceptable risk profile for a diagnostic/therapeutic colonoscopy or CT colography.
Colon cancer screening tests are an important tool to help detect and prevent colon cancer. With appropriate screening and early detection, colon cancer can be prevented and treated. There are many options for colon cancer screening available today. Colonoscopy remains the best colorectal cancer screening test as it can screen, detect, treat, prevent, and cure most significant colon lesions during one exam.
Talk to your doctor about which colon screening test is right for you.
