cologuard vs colonoscopy screening

[TWR]

Does anyone have an opinion regarding the cologuard?  Has anyone used it for their patient.  Would you recommend it for an initial screening of a 51 y/o male with no particular risk factors? TIA

[ventana]

I had looked into it previously

 

do not recomend it unless someone demands it

 

the new FIT (hemocult) test is fine for annual testing (only positive with human hgb)

 

with normal risk factor yearly FIT is okay instead of colonoscoy - but make sure you know rather they are "average risk" 

• A personal history of colorectal cancer or certain types of polyps
• A family history of colorectal cancer
• A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
• A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
• A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer
• my personal addition - hx of certain CA or CA treatment in which colon CA rates are higher after remission/treatment

 

 

excellent resource

https://www.cdphp.com/-/media/files/providers/toolkits/colorectal-cancer/colorectal-cancer-screening-with-fit-vs-cologuard.pdf

 

 

 

In my practice - yearly FIT starting at age 50 (CAUTION IT IS GOING TO CHANGE TO 45 SOON - KEEPS YOUR EARS OPEN)

If someone is high risk -colonoscopy 10 yrs before age of early Dx or other factor

I don't really recommend Cologard - to darn expensive....

[Probasesteal]

I agree with the above. I've done them, but only when the patient demands them or after a long discussion REFUSES colonoscopy.

CYA documentation!

[sas5814]

I did one last year instead of a colonoscopy. I am low risk and was comfortable making an informed decision. It is a niche product and when my time comes again I'll have the colonoscopy.