Cologuard Question & Answer
Borland Groover Clinic 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
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 50 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
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 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 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
coHection. A physician will review the results of the study and will order additional tests as needed.
All positive Cologuardi!> results should be followed by a diagnostic colonoscopy. Following a negative
result, patients should continue participating in a routine screening program. Guidelines have not been
established for how frequently the Cologuard® test should be performed.
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 co lo rectal 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 new test, it may take a year or longer for insurance companies to update their insurance coverage policies. 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.
If a positive Cologuard® test is found, a colonoscopy will be needed. In this case, the colonoscopy may be covered by insurance as “diagnostic” versus “screening” and additional co-pays or deductibles may apply. Patients considering the Cologuard® test should check with their insurance provider first to determine coverage.
Who should consider Cologuard®?
Those patients who refuse a screening colonoscopy AND if the Cologuard is positive would accept a diagnostic colonoscopy.
Those patients with a chronic illness which raises their individual risk for screening colonoscopy AND have an acceptable risk profile for a diagnostic/therapeutic colonoscopy.
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.
Borland Groover Clinic appreciates our ability to participate in your patients care.