Cologuard Stool Test vs. Colonoscopy

Welcome to another edition of the Doctor's Note where we talk about what's on our minds when it comes to your health. 

Today we're focusing on the increasing importance of colon cancer screening and breaking down new testing options like the Cologuard Plus stool test versus the traditional colonoscopy. There’s a lot of misinformation and confusion surrounding these choices, but understanding the benefits, limitations, and best candidates for each can save lives.

In this week’s podcast, I laid out the pressing need for effective colon cancer screening as colorectal cancer becomes increasingly prevalent, especially among younger adults. The statistics are sobering: colorectal cancer is the second leading cause of cancer-related death in the United States, and early detection dramatically improves outcomes. Despite advances in both blood marker and DNA-based stool tests, colonoscopy remains the gold standard for high-risk patients. However, the newly FDA-Approved Cologuard Plus is now offering many adults a highly accurate, non-invasive, and insurance-covered alternative that can be completed at home, improving screening adherence rates. Watch the video, write a few highlights down and take action. Cancer screening is not an option. 

PODCAST NOTES 

• Colon cancer screening is essential due to high incidence and mortality rates: Colorectal cancer is the second leading cause of cancer death in the U.S., causing over 53,000 deaths each year. Early detection through consistent screening, especially of pre-cancerous lesions and polyps, is vital for preventing unnecessary deaths and dramatically increases the chance of successful treatment or even cure.

• The screening age has shifted lower due to rising cases in younger adults: Previously, screening typically began at age 50, but due to a noticeable increase in younger individuals being diagnosed with colon cancer, all major cancer societies now recommend starting routine screening at age 45. Those with risk factors or a strong family history may need to begin screening even earlier.

• Screening participation remains insufficient among American adults: Only 40% of adults over age 45 are up-to-date with their screenings. This number drops even further to just 17% for adults in the 40 to 49 age group. These low screening rates contribute to the preventable loss of life and underscore the need for easier, more accessible testing options.

• Cologuard Plus delivers advanced detection by combining blood and DNA markers: The Cologuard Plus test fuses an enhanced hemoglobin (FIT) assay with detection of abnormal DNA markers associated with colorectal cancer. This improved dual approach provides higher sensitivity (95%) and specificity (94%) than previous stool tests, making it a compelling, non-invasive option for many.

• Colonoscopy remains critically important for high-risk patients and certain findings: Individuals with a personal or family history of colon cancer or polyps, positive prior screening tests, inflammatory bowel diseases, or suspicious symptoms (like rectal bleeding) are strongly advised to undergo colonoscopy. This procedure allows for direct visualization, removal, and biopsy of precancerous or cancerous lesions in one appointment.

• Cologuard Plus offers convenience, no prep, and improved patient adherence: For low-risk patients, Cologuard Plus can be completed at home, requires no dietary or bowel preparation, and doesn’t result in missed work or vacation days. The simplicity and comfort of an at-home test mean more people are likely to follow through with regular screening.

• Negative Cologuard Plus tests require more frequent repetition than colonoscopies: If your Cologuard Plus test returns negative for cancer or polyps, it should be repeated every three years. In contrast, if a colonoscopy is clear of polyps or concerning findings, the next colonoscopy can typically be spaced out for ten years, unless you develop new symptoms or risk factors.

• The majority of insurance plans now cover Cologuard Plus with no copay: Over 96% of patients benefit from coverage for Cologuard Plus, making it a cost-effective option that removes financial barriers. Most patients will not have any out-of-pocket expenses, adding another layer of accessibility to regular screening.

No matter which screening method you choose, the most important thing is getting screened at the right time. If you’re 45 or older, or if you have specific risk factors or symptoms, make screening for colon cancer a top health priority. Talk to your healthcare provider to determine the best approach for you, and encourage your loved ones to do the same. 

Consistent screening saves lives, and today’s tools make it easier than ever. Take control of your health and don’t delay your colon cancer screening! 

Stay educated. Stay healthy.

Till next week.