Cologuard vs. Colonoscopy: What You Need to Know

More and more first time colon cancer screening patients are choosing Cologuard over a colonoscopy, according to a new Exact Sciences study.

Since Cologuard’s arrival in 2016, the number of new patients seeking a colonoscopy has dipped 6 percent.  Cologuard patients continue to more than double each year, and as of 2019, 15 percent of first time patients are choosing the at-home test vs. a colonoscopy, and it’s not hard to see why – at least on the surface.

Cologuard has poured millions of dollars into a marketing campaign featuring a likeable talking box equipped with the Cologuard logo that showcases the new, easy way of detecting colon cancer. One of the greatest benefits of Cologuard is the absence of the pre-procedure prep of a colonoscopy as well as the noticeable decrease in cost vs. a colonoscopy.  However, Cologuard is far from becoming the gold standard in colon cancer screenings, and here is why:

  • Cologuard can miss up to 8 percent of colon cancer and more than 50% of pre-cancerous polyps.
  • Cologuard will need to be repeated every three years vs. 10 years with a colonoscopy if no polyps or cancer is found.
  • A positive Cologuard test will lead to a diagnostic colonoscopy, which will not be covered as a preventative screening by health insurance, thus those cost savings now become a cost burden.

Colonoscopy is the Gold Standard in Colon Cancer Prevention

Colonoscopy is the only test that can detect and treat colon cancer. If polyps are found during a colonoscopy, they can be immediately removed and sent to the lab for biopsy.  It also is the only test that examines the entire length of the colon.  Screening colonoscopies are also covered under insurance plans as a preventative procedure – fully covered.  If polyps are found, it will not change insurance coverage, unlike a positive Cologuard test, which require a diagnostic colonoscopy.

The main disadvantages of a colonoscopy are the dietary restrictions and bowel prep. You will be restricted to a low-fiber or clear liquid diet prior to your exam, and patients often find the bowel preparation process unpleasant.

If you have to get screened for colon cancer, do yourself a favor and choose a colonoscopy instead of Cologuard. You will rest assured you are getting the most thorough colon cancer screening available. After all, isn’t that the point of being screened in the first place?