Screening for colon cancer has come a long way. Lifesaving tests such as colonoscopies, sigmoidoscopies, and barium enemas can identify precancerous lesions in the colon in addition to detecting actual cancers. Removing these precancerous growths has proven very effective at preventing future colon cancers: Colon cancer rates have plummeted approximately 30 percent in the past decade, and colon cancer mortality is on the decline as well.
The problem is that many people find these tests and their preparations unappealing, and avoid them. That’s why a new at-home colon cancer screening test called Cologuard is attracting so much attention. Users collect a stool sample at home and send it to a lab where it’s analyzed for evidence of gastrointestinal bleeding (a symptom that can indicate colon cancer) and DNA mutations associated with colon cancer. Not only is it convenient, it’s effective. Cologuard detects 92 percent of colon cancers and 42 percent of advanced precancerous lesions. However, it’s not yet the game-changer some are touting it to be.
Is it covered by insurance?
The test costs $599. It’s covered by Medicare, but private insurers are not yet on board.
How should I interpret the results?
A positive test means you still have to undergo a diagnostic colonoscopy to see if you have cancer or a precancerous growth. Of the people with a positive test who subsequently undergo a colonoscopy, only some will turn out to have a worrisome lesion. However, it’s a potential lifesaver for those who find a cancerous or precancerous lesion.
The big concern about Cologuard is the false sense of security it may provide to those with a negative result. A negative result doesn’t guarantee that you’re free of disease, and it shouldn’t dissuade you from following the recommended guidelines for colon cancer screening.
What are the current screening guidelines?
Current guidelines include a baseline procedure at age 50 for people who are not at increased risk (those with no family history of colon cancer). Some experts advocate that screening should start at age 40 for African-Americans. The most common screening procedures include a colonoscopy every 10 years (more often if polyps are found), a sigmoidoscopy (a more limited procedure) every five years, or annual stool blood tests.
So is Cologuard worthwhile?
It’s too early to know the impact Cologuard will have on colon cancer mortality or the role it will ultimately play in colon cancer screening. Current cancer screening guidelines haven’t changed, and even using the new test every year still requires you to have recommended screening procedures as per the existing guidelines.