cologuard vs colonoscopy

[battanim]

I’m on watch and wait for about five years now. So far, a most indolent diagnosis. My question is about colon cancer screening. Is the non-invasive cologuard acceptable rather than a colonoscopy? I had a colonoscopy ten years ago and was clean. I’m due again and am wondering about cologuard vs. colonoscopy.

[CycleWonder]

I did the Cologuard, which my CLL specialist was fine with. My husband had a colonoscopy and the doctor was not wearing a mask, which upset my husband as he did not want to expose me to anything. My husband would have said something but immediately after the doctor walked in, they put him out.

This was the main reason I chose the Cologuard. Less exposure to idiots.

[cajunjeff]

The cologuard test will always be inferior to a colonoscopy.

That said, the cologuard test is better than nothing. It’s inexpensive, much less invasive and easy to do.

I chose cologuard during the pandemic to avoid COVID exposure risk (and probably to avoid the hassle of a colonoscopy and all the prep the night before).

The most unpleasant part of cologuard for me, besides the logistics and grossness of pooping in a box, was when I got a letter in the mail from cologuard saying I was positive for colon cancer. Yikes.

I freaked out. I immediately called my dr friend who does my colonoscopies, I had done one about 12 yrs ago. He told me it was probably no big deal. Evidently it’s not a large percentage of positive cologuard tests that are actually positive for true colon cancer.

I ended up having one small polyp removed during my colonoscopy, so credit cologuard for picking that up. I return in five yrs for repeat colonoscopy. Since I had a polyp I’ll skip cologuard in the future.

So I think cologuard is probably okay to do. There is that slight chance it misses something a colonoscopy would have picked up.

[Shepherd777]

My gastroenterologist said if you have ever had a polyp in your colon, previous gut blockage, IBS, IBD, bleeding ulcers or have any colon cancer in your family like a brother, mother or grandparent you need the colonoscopy.

[HopeME]

My wife didn’t have a history of colon cancer in her family and at the age of 50, after my insistence, she got a colonoscopy. The doctor said I’m glad you came when you did. If you waited another year we would be having a different conversation and it wouldn’t be a happy one. I had a friend about the same age who had the same experience. He is one of the fittest people I know. He had his colonoscopy dome just before Covid. Had Covid arrived a little earlier he would have had the procedure delayed and he’d be dead.

I think it is a big mistake for most people and certainly CLL patients to not have regular colonoscopies.

Best,

Mark

[GMa27]

would never rely on Cologuard.

colonoscopies are every 5 years thru age 80. they keep

changing the guidelines every few years. used to be every

10 years but they found people had issues and maybe it

was way too long. i go every 5 years.

if you don't have insurance, then I would start with Cologuard- maybe

every 3 to 4 years and then

and save up for the real test every 7 or 8 years. well worth it.

[scryer99]

If you have a family history of colon cancer, you should be getting colonoscopies, not Cologuard. This is referenced in Cologuard’s advertising in the US.

[scryer99]

The diagnostic standard for colonoscopies in the US is every ten years starting at 50. and that will be covered under better insurance plans at 100% as preventative.

If you have either family history or past findings of concern with previous colonoscopies, they will ramp up the schedule. CLL also carries some additional risk; colon cancer has some relevance as a secondary cancer (like skin cancer)

If that second paragraph applies to you, you should not be getting Cologuard in place of a colonoscopy. Cologuard does state this.

I have all three risk factors and am on a three year schedule. If i get ten punches on my card I get a free coffee. My surgeon gets a BMW, but fair trade for me not getting colon cancer which is no fun.

[DebDenC in reply to scryer99]

One slight update to this.. my son=in-law is a colorectal surgeon who is a spokesman for the local colorectal cancer coalition. The newest screening guidelines say to start screening at age 45. If there is a family history, it may be earlier. Between age 75 and 85, it should be decided on an individual basis between patient and doctor, however, he recently had a 93 year old patient with cancer who really wanted colorectal cancer surgery, but was physically unable to undergo it. If he had continued having colonoscopies after age 75, the cancer would have been discovered earlier when he could have undergone surgery.

cancer.org/cancer/colon-rec...

[scryer99 in reply to DebDenC]

Thanks - I had in the back of my head they were thinking about updating the 50-year mark, but insurance I'm not sure has caught up yet. They certainly charged me for my 53-year and 56-year after doing the 50-year.

My dad ended up in similar straits to the patient you described. His situation drove home to me that putting things off can sometimes close off some options.

[scryer99]

Sorry, misread it… I think we are in agreement.

[HopeME]

Hi Jammin:

Given the higher risk of secondary cancers for CLL patients I think it is more prudent to have the colonoscopy done. That is me being safe I suppose but it seems like an easy thing to do.

Best,

Mark

[MisfitK]

Not sure if this is possible, but b/c I was young (way under 50, but big family history), I got a virtual colonoscopy, which is much less invasive, but just as diagnostic. Now, if they find something, you're still stuck doing the regular thing. And the prep is still there and horrid. But I was avoiding propophyl reactions (b/c my 1st time was not good), so my GI and I agreed we could try this 1st (since I said 2/3 it's the best play, 1/3 it wasn't - aka, if I had no issues or I had so many issues it freaked a doc out, it would be good to plan and not panic - so, VC was the way to go. If I had just a few polyps (the 3rd option), the regular would have been the right call b/c I'd only do prep and appointments once). Thankfully, I was clear, so I made the right call for that one, although I'll probably do a regular in 2 more years, when I'll be 5 years from the last one...

[Judyanne]

Hi, I have no family history of colon cancer and only one benign polyp found in previous colonoscopies. However, this time found 5 polyps, 2 of which were precancerous. Go back in 3 years.