Colonoscopy, passage of a lighted flexible scope through the large intestine, is the gold standard procedure for detecting colon cancer and the polyps that develop into it. Many individuals, however, avoid colonoscopy because of the laxatives required for preparation, the anesthesia, the small risk of bowel perforation, or the risk of contamination and infection from the procedure itself.
Cologuard is a new screening test much more accurate than the old stool test for occult blood. There is no risk. A stool specimen is mailed to the testing facility and evaluated for the presence of specific protein secreted by intestinal polyps or tumors. The patient is then informed by the doctor’s office of the result. A positive result should be followed by colonoscopy. If a polyp is found, it can be excised during the procedure. If a cancer is found, surgery is needed.
The Cologuard test has 90% sensitivity in detecting polyps or tumors. One out of 8 patients tested, however, will have a false positive result. He will then require colonoscopy, which he would otherwise have needed for screening anyway.
Several months ago, our Cologuard test detected cancer in a patient who had never had colonoscopy. Colonoscopy confirmed the presence of tumor, and it was surgically removed with no evidence of spread.
Cologuard is not recommended for persons with a family history of colon cancer or personal history of polyps. Those individuals should have colonoscopy.
The Cologuard test is paid for by Medicare under certain criteria, and can be performed every 3 years. Call our office for more information regarding other insurance companies that may cover the test or to set it up, (949) 600-5100.
Allan Sosin, MD