Doctors stress the importance of colon cancer screening for a reason. Early detection makes a huge difference. When doctors detect the disease in early stages, five-year survival rates are as high as 70 to 97 percent.
Sadly, far too many patients ignore the call for regular colonoscopies after age 50, despite the clear value of this screening tool.
What if you had another screening option — one you could do at home with minimal prep? That’s the idea behind the Cologuard test, approved by the FDA in 2014.
Cologuard is still relatively new and not that widespread. But that could change in the future as patients and doctors learn more about it.
“At-home testing may be a way to ensure more of these patients have access to early diagnosis and life-saving treatment.”
Charis Eng, MD, PhD
Founding Chairwoman of the Genomic Medicine Institute
Before FDA approval, researchers tested Cologuard and published results of a clinical trial, sponsored by the test’s manufacturer, Exact Sciences. The multi-center trial included around 10,000 patients. For comparison, these patients had both at-home screening and colonoscopy.
According to results, the Cologuard test identified roughly 92 percent of cancers also diagnosed through colonoscopy. The test does this by extracting and analyzing DNA from a person’s stool sample. The test has a high rate of sensitivity. The trial results are highly positive, although further research will determine if the rate remains so high.
It’s important to note this is not genetics in the sense of family history. This at-home test is looking for signs of DNA abnormalities that occur as a result of cancer — not the genetic mutations that put you at risk of cancer in the first place. Because of that, the test is designed for patients above age 50 who have an average risk of cancer.
Fears of colonoscopy — whether they’re valid or not — do keep certain patients from having them. At-home testing may help ensure more of these patients have access to early diagnosis and life-saving treatment for colon cancer.
The process is pretty simple. A doctor prescribes the test at an annual check-up or other office visit. You will then receive a test kit to collect your own stool sample privately at home. The test includes detailed instructions — complete with helpful pictures — on how to gather the sample and where to send it for analysis.
After a couple of weeks, your doctor receives the test results and then discusses them with you. If they are negative, you likely will not need to follow up further until you’re due for another screening. If they are positive, you will need a colonoscopy to confirm the diagnosis.
In other words, this at-home test does not replace colonoscopies, but it could reduce the number of people who need them.
Payment is another question. Cologuard is new, and you would need to ask your insurance company directly about coverage. But Medicare did announce coverage in 2014, and insurance provider Anthem recently announced coverage, as well.
Whether at-home screening takes off throughout the country remains to be seen. But if it can help keep patients with easily preventable cancer from slipping through the cracks, I see a lot of promise in the approach.