Cologuard vs Colonoscopy

[Teacher Terry]

I can’t do the color guard because I have hemorrhoids that bleed occasionally. Had colonoscopy 10 years ago. Not sure if I will have one more at 70 or not. A friend of mine had complications but survived.

[check6]

I am impressed with the board knowledge of Cologuard. I have been an investor with the company Exact Science (EXAS) for over three years and plan to use Cologuard for my next screening.

[zinger1457]

Quote:

Originally Posted by RAE Just had my annual doctor appt. the other day (general wellness check), and he highly recommended the cologuard test for me. He said he thinks it is actually a better way to go for guys like me (who have no prior history of polyps, and no family history of colon cancer). He said insurance will definitely cover it. So, I agreed.......just waiting for the kit to come in the mail.

I would recommend you check with your insurance company beforehand. My insurer (BCBS) said they would cover the cost but only if my PCP submits a referral to them before taking the test. The lab that performs the test is not part of their network and without the referral they would not cover the cost.

[RAE]

Quote:

Originally Posted by zinger1457 I would recommend you check with your insurance company beforehand. My insurer (BCBS) said they would cover the cost but only if my PCP submits a referral to them before taking the test. The lab that performs the test is not part of their network and without the referral they would not cover the cost.

Well, my PCP was going to order the test for me, so I assume that is what BCBS needs.

[plsprius]

By the way, an alternative stool test, FIT (fecal immunochemical test), is also an effective and non-invasive screening test, similar to the very expensive Cologuard, and only costs about $25. It's also done via a mail-in sample, or in the doctor's office or even at home.

The FIT has been FDA-cleared for direct-to-consumer, so you can buy it on Amazon.

In any case, the best screening test for you is the one you will actually do, be it colonoscopy, FIT, or Cologuard, etc. Pick your favorite and do it!

PS. I'm not a doctor, so YMMV. But see this article that makes these same points (there's a lot on the web about this): FIT Test for Colorectal Cancer Screening | Berkeley Wellness

[TrvlBug]

Quote:

Originally Posted by Teacher Terry I can’t do the color guard because I have hemorrhoids that bleed occasionally. Had colonoscopy 10 years ago. Not sure if I will have one more at 70 or not. A friend of mine had complications but survived.

According to my dr. that's no longer an issue with Cologuard. You should discuss with your dr. to see if you are eligible.

[Trooper]

As the OP I want to post a follow-up. After weighing all the facts, pros/cons, etc. I decided to go with Cologuard. My test came back negative, so I suppose I will repeat the process in 3 years. I am 60 now.

Interestingly enough my DW, who at first was dead set against Cologuard, opted for Cologuard after a visit with her primary doctor. Her test came back positive, so we scheduled a colonoscopy for her in a couple of weeks. Her gastroenterologist had NOTHING good to say about Cologuard. Says it was rushed to market without adequate testing. I'm trying to take his opinions with a grain of salt given where his bread is buttered, but it made me wonder if 1) did my wife get a false positive? 2) did I get a false negative? and 3) should my next screening be a colonoscopy?

[Teacher Terry]

Thug, thanks for the information

[ShokWaveRider]

I had a colonoscopy 3 years ago, clean as a whistle.... BUT, after the procedure I got "ischemic colitis". Without getting into the details it was NOT fun and the pain was almost unbearable. Doc said it was caused by dehydration as a result of the prep. Took 2 weeks on a very boring liquid and low residue diet to fix it...… Never Again.

[RAE]

Quote:

Originally Posted by Trooper Interestingly enough my DW, who at first was dead set against Cologuard, opted for Cologuard after a visit with her primary doctor. Her test came back positive, so we scheduled a colonoscopy for her in a couple of weeks. Her gastroenterologist had NOTHING good to say about Cologuard. Says it was rushed to market without adequate testing. I'm trying to take his opinions with a grain of salt given where his bread is buttered, but it made me wonder if 1) did my wife get a false positive? 2) did I get a false negative? and 3) should my next screening be a colonoscopy?

I think that if my Cologuard comes back positive (and I haven't done it yet), my next step would probably be to do the FIT (fecal blood) test, to see how that comes out. If that also came back positive, then I would definitely schedule the colonoscopy. False positives are always possible with both tests, but I believe there are more false positives (percentage-wise) with Cologuard than with the FIT. The FIT basically just looks for the presence of human blood in the stool, so it seems like it would be pretty hard to screw that up.

[RAE]

Here is a short article (written by a gastroenterologist) comparing Cologuard, colonoscopy, and the FIT test (the article is a few years old now, but still interesting).

https://www.medpagetoday.com/gastroe...terology/47428

The false positive rate with Cologuard is about 13%, whereas the false positive rate with FIT is only 5%.

[check6]

Quote:

Originally Posted by RAE The FIT basically just looks for the presence of human blood in the stool, so it seems like it would be pretty hard to screw that up.

The problem with FIT is that if it comes back positive (blood in sample) you might already be at Stage 2/3. Cologuard detects the "cancer" in polyp stage.

[check6]

The best thing about Cologuard is that more people will be screened than otherwise would because of their fear/prepping of/for a colonoscopy.

[Corporateburnout]

I just had my 3rd colonoscopy yesterday due to some rectal bleeding from internal hemorrhoids. My PCP recommended the procedure even though my last colonoscopy 4 years ago was clean. Well the doctor removed 3 small polyps but found a larger mass at the ileocecal valve that he was not able to remove but took a couple of samples for biopsy. He said that good thing that my PCP ordered the test otherwise this would have gone unnoticed. Awaiting the biopsy results but he has already scheduled an appointment with a colorectal surgeon in two weeks to discuss treatment options.

I'm 65 with no family history of colon cancer. So for those who think that 10 years between colonoscopies is sufficient think again.

[Teacher Terry]

Everyone needs to decide for themselves.

[Dtail]

Quote:

Originally Posted by Corporateburnout I just had my 3rd colonoscopy yesterday due to some rectal bleeding from internal hemorrhoids. My PCP recommended the procedure even though my last colonoscopy 4 years ago was clean. Well the doctor removed 3 small polyps but found a larger mass at the ileocecal valve that he was not able to remove but took a couple of samples for biopsy. He said that good thing that my PCP ordered the test otherwise this would have gone unnoticed. Awaiting the biopsy results but he has already scheduled an appointment with a colorectal surgeon in two weeks to discuss treatment options. I'm 65 with no family history of colon cancer. So for those who think that 10 years between colonoscopies is sufficient think again.

Hope for the best for you.
We get one every 5 years.