Is the Cologuard Test a Good Alternative to a Colonoscopy? (Corrected)

I have been corrected. The financial hit of a follow up colonoscopy has been eliminated by the Biden administration. (I hadn’t heard this news from the sources I refer to.) Of course, if somebody doesn’t want a colonoscopy, and does the Cologuard and it’s positive, they still have a dilemma to deal with.

9 Responses to “Is the Cologuard Test a Good Alternative to a Colonoscopy? (Corrected)”


  1. 1 Gail Alger-Wilcox April 29, 2023 at 6:46 pm

    That was interesting and very informative. Thank you Dr.

  2. 2 Allen W. Ditto, M.D. April 30, 2023 at 5:57 pm

    I believe you are wrong about the insurance coverage for a follow-up colonoscopy in light of a positive fecal colon cancer screening test. The following should be a little more up-to-date and reassuring for those (most of us) worried about medical expenses. A big thank you to the Biden administration! I would like to know if you agree, and if so, will you issue a correction?

    https://www.asge.org/screenforcoloncancer/news/2022/01/18/new-cost-sharing-guidance-for-colonoscopies-after-other-positive-screening-tests

    https://www.bcbsks.com/latest-news/update-colonoscopies-follow-positive-cologuard-test

    https://gastro.org/press-releases/no-more-surprise-bills-private-insurance-plans-must-cover-the-full-colorectal-cancer-screening-continuum/

    Click to access aca-part-51.pdf

    For the immediately above please see Q7 and Q8.

  3. 7 Allen W. Ditto, M.D. April 30, 2023 at 9:50 pm

    Thank you for your rapid correction. Things sneak up on us all the time.

    The dilemma for a patient not wanting a colonoscopy as a screening test for colon cancer (somewhat understandable) is for them to understand that if the fecal screening test is positive, the colonoscopy is usually both diagnostic and treatment for the issue, if the screening test was not a false positive or if the issue making the test positive is not too large or advanced to be remedied by the colonoscopist. There is really little point in doing a screening test for a medical issue if the patient doesn’t want to have the problem you’re screening for further evaluated or treated.

    Here is a very interesting take on the advantages of having a screening colonoscopy:
    https://www.health.com/colonoscopy-screening-effectiveness-study-6822546

    I myself have had three colonoscopies since I was 50 years old. The first one was fine. The second procedure, at age 60 years, found an adenomatous polyp, which may be precancerous. The third one, at a five-year interval, also found another adenomatous polyp. So it is now recommended by my GI doctor to have another one at a five-year interval. This is somewhat aggressive for a less than 1 mm-sized polyp. However, I also have Barrett’s esophagus so she does a combined procedure. I have never taken recreational drugs, but I will say that the 8 hours after my combination procedure is probably the most relaxed and contented that I ever feel. The miracle of modern chemistry!

    When my next colonoscopy/gastroscopy is due to be done, I will be 70 years old. Then I will have to confront the utility of having further screenings as I “age out” of a possible benefit compared to the risk from the procedures.

    • 8 acountrydoctorwrites April 30, 2023 at 9:55 pm

      I had a colonoscopy at age 50 with the hyperplastic polyp. I had uncles and aunts With colon cancer, but my dad didn’t have it. I have Barrett’s I’ve had to offer endoscopies. I’ll be 70 this summer. I have not had a colonoscopy since age 50 and I have not had an upper endoscopy since age 55+/- So I am a bad patient. Remember the cancer risk of an adenomatous polyp is only 2%.

  4. 9 karen usavage May 4, 2023 at 12:42 pm

    I am 82 and I opted to stop mammograms at 75 despite the fact that my grandmother had breast cancer in her 60s and one half sister had B.C in her 30s. I have never had any abnormalities. I have had 3 cologuards spaced apart. all normal. I refused osteoporosis screening from the get go. no history in family and I am a sturdy woman. i go for my annual physical, take some meds for familial hyperliipidemis. Had AVR and by pass at 69. I did have cataracts done, but I am strictly quality of life,pain free maintenance now. I have friends who run the gamut of doing all kinds of things; then they are miserable for weeks and months. There is a time to quit and just enjoy life.


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