Cologuard spends millions on advertising, but patients can’t get all the information they need in a TV commercial. It’s true, that Cologuard offers benefits of comfort and convenience, but the Cologuard test is not recommended by GCSA physicians as a replacement for a colonoscopy.
Colon cancer claims more than 50,000 lives each year and is the 2nd leading cause of cancer death in the United States. Colon cancer can be prevented, treated, and defeated – but only with early and accurate detection.
Any screening for colon cancer is better than no screening, but patients should know the pros and cons before making a final decision.
Types Of Colorectal Cancer (CRC) Screening
Because colon cancer begins as growths called polyps, finding and removing polyps is the best way to prevent colon cancer. There are three types of CRC screening:
- Colonoscopy – 95% of large polyps detected
- Stool DNA (Cologuard) – 42% of large polyps detected
- Fecal immunochemical test (FIT) – 30% of large polyps detected
Colonoscopy is the gold standard for finding polyps. If polyps are discovered during a colonoscopy, they are removed during the same single procedure. This eliminates the need for additional procedures or tests.
If polyps are found through FIT or a Cologuard test, a colonoscopy should be performed to remove the polyps.
Unfortunately, the majority of large polyps are not detected by the FIT and Cologuard tests. When polyps are not found and removed, it increases the risk of developing colon cancer.
Cologuard Test: Detection And Not Prevention
The Cologuard test is designed to detect cancer, not to prevent it. The Cologuard can only detect 42% of large polyps, whereas a colonoscopy can detect 95% of large polyps.
When polyps are detected during a colonoscopy, they are removed at the same time. If polyps are detected with the Cologuard, a colonoscopy should be performed to remove them.
The majority of large precancerous polyps cannot be detected with Cologuard. This can give patients the false feeling that they are preventing colon cancer by taking the Cologuard test.
Save Time & Money
If you are at high risk for colorectal cancer, which includes:
- a family history of colon cancer
- current symptoms
- a previous colonoscopy that revealed polyps
You should skip the Cologuard test.
It will save you time, money, and the frustration of having both tests since a colonoscopy is required for high-risk patients.
If your primary care provider recommends Cologuard and you are at high risk, you should consult a specialist before having the test.
How Does The Cologuard Test Work?
The Cologuard test is a stool DNA test that looks for the presence of microscopic blood in the stool and altered DNA. It is carried out using a home kit that includes a container for a stool sample. This sample is then sent to a laboratory for testing.
How Accurate Is The Cologuard Test?
Cologuard can detect 92% of cancers but only 42% of large precancerous polyps.
Cologuard detects cancer better than FIT (92% versus 70% for FIT), but the false positive rate is higher. Cologuard has a false positive rate of 12%, and this rate increases with age.
Cologuard is less accurate than a colonoscopy in detecting polyps of any size. A colonoscopy can detect 95% of large polyps and Cologuard only 42%.
Frequently Asked Questions About Cologuard
Can Cologuard Detect Polyps?
Yes, Cologuard can detect polyps. However, detecting large polyps (the precursors to colon cancer) is less than half the accuracy of a colonoscopy.
Is The Cologuard Test As Effective As A Colonoscopy?
No, the Cologuard test is not as effective as a colonoscopy. Detection and removal of polyps are critical to colon cancer prevention, and Cologuard detects large precancerous polyps in only 42% of cases. A colonoscopy detects the same polyps in 95% of cases and they are removed during the same procedure.
What Does A Positive Cologuard Test Mean?
If the Cologuard test is positive, it may mean the presence of colon cancer or polyps. After a positive Cologuard test, a colonoscopy is needed to get a definitive answer. The Cologuard test has a false positive rate of 12%, which means that 1 in 10 positive tests will incorrectly identify cancer or polyps.
Can Cologuard Detect Cancer?
Yes, the Cologuard test can detect cancer in 92% of cases. However, preventing colon cancer is better than identifying it once you have it. The best way to prevent colon cancer is to identify and remove precancerous polyps that don’t turn into cancer later. Cologuard only detects 42% of dangerous large polyps that can turn into colon cancer.
Can I Use Cologuard Instead Of A Colonoscopy?
Cologuard is not designed to replace a colonoscopy, although advertisements may suggest otherwise. In 58% of cases, dangerous precancerous polyps are not detected with Cologuard, which is significantly less effective than a colonoscopy. However, Cologuard may be an option for some patients who insist on not having a colonoscopy or for those who are not healthy enough to have a colonoscopy. Even a 42% chance of detection is better than no detection at all.
How Long Is Cologuard Good For?
A Cologuard test should be performed every three years rather than annually due to the higher cost and false-positive rates compared to an annual FIT. Further research is needed to determine how often the Cologuard test should be performed.
What Is Cologuard’s False Positive Rate?
Cologuard’s false positive rate is 12% or just over 1 in 10.
Is A Stool Sample As Good As A Colonoscopy?
FIT and Cologuard tests performed on stool samples are not as effective at identifying large, precancerous polyps that lead to colon cancer. FIT and Cologuard tests are more effective than no test at all.
How Accurate Is The Stool Test For Colon Cancer?
There are two types of stool tests for colon cancer. Fecal immunochemical test (FIT) and stool DNA (Cologuard). The FIT detects 70% of colon cancers and 30% of large colorectal polyps. The Stool DNA/Cologuard detects 92% of cancers and 42% of large colorectal polyps.
How Much Does Cologuard Cost?
The cost of a Cologuard is around $500. Some of this cost may be covered by some insurance depending on your plan, co-pay, and deductible. Diagnostic tests are subject to deductible and coinsurance.
Screening colonoscopies are not subject to coinsurance and deductible and generally have no out-of-pocket costs for patients.
What Can Cologuard Detect?
Cologuard can detect 92% of cancers and 42% of large precancerous polyps, the precursor to colon cancer.
Who Is Cologuard Good For?
Cologuard may be an option for patients who insist on not having a colonoscopy or who are not healthy enough for the procedure. Some patients may decide that the risks associated with a colonoscopy outweigh the benefits of increased detection.
Any colon cancer screening test is better than no test at all. If the Cologuard test is positive, a colonoscopy will be required.