Cologuard vs colonoscopy: A question of convenience, money

March is Colon Cancer Awareness Month

Many people have postponed all sorts of medical screenings during the COVID-19 pandemic. And while all medical tests are important, screening for colon cancer requires you to be thoughtful in how you do it.

SAN ANTONIO – Many people have postponed all sorts of medical screenings during the COVID-19 pandemic. And while all medical tests are important, screening for colon cancer requires you to be thoughtful in how you do it.

The wrong choice could add pain in the pocketbook or even potentially force you to miss a diagnosis.

The choice between tests is wide, but some gastroenterologists want to make sure you know what you are signing up for medically as well as financially. As we mark Colon Cancer Awareness Month, you may be getting reminded it’s time to make that choice.

The screening test, Cologuard, is popular for a number of reasons. Cologuard is a relatively inexpensive in-home screening test that checks for DNA and blood abnormalities that would indicate potential cancer growth. It does not require the pre-treatment of a colonoscopy, meaning no nasty Koolaid-tasting stuff to choke down to clean your colon or fasting the day before.

The problem is, if you really, really need accuracy, it’s not the best choice.

Dr. Peresh Mehta, of Gastroenterology Consultants of San Antonio, wants to make sure people who have a family history of colon cancer or gastro complications know the limitations.

“That test is about 70% good at finding cancer, but it’s only about 20% good at finding the big polyps, which are the ones that are usually precancerous, and those are the ones you really want to get out with a colonoscopy,” Mehta said.

In contrast, a full colonoscopy is 95% accurate at locating large polyps, which can be biopsied and sent to a lab for full analysis.

If a Cologuard test does indicate the presence of polyps, you will likely now need a colonoscopy, too. That’s where the financial issue comes up. Many insurance companies will only cover the first screening.

“They’re just saying, ‘You have one screening, one mammography, one pap smear, one colon screening, so if you use it, tough luck. Now you need to pay,’” Mehta said.

Cologuard is also for people who are at average risk for colorectal cancer, and do not have issues like IBD or a family history of colorectal cancer.

“The best thing to do is colonoscopy. There’s no doubt. Nobody puts that in question when it’s done right. You are very protected, about as good as you can be protected against any cancer,” Mehta said.

According to Cologuard’s website, more than 95% of patients nationwide pay no out-of-pocket expenses, based on eligible patients ages 50-75 who are at average risk for colon cancer and have no symptoms. Cologuard is covered by Medicare and Medicare Advantage with no copay or deductible for eligible patients ages 50 to 85.

The website does recommend that patients find out the insurance requirements in the event of a positive result for colon cancer.


About the Author:

Ursula Pari has been a staple of television news in Texas at KSAT 12 News since 1996 and a veteran of broadcast journalism for more than 30 years.