Polyps – the Down Side of Cologuard

I’ve written before about my first coloscopy. I was only in my early 40s at the time but was having a bowel problem so my doctor first ordered a rectal exam. This exam consisted of running a short scope up my rectum. If found nothing.

That’s when the doctor ordered a colonoscopy. The clearing out solution made me really sick. Then the doctor who performed the colonoscopy got me on the table and told me that I was a big guy and didn’t need anything, so he proceeded to insert the scope without giving me anything. Between the air being pumped into my colon and the scope being shoved through my colon and large intestine, the experience was excruciating. The doctor said that the only thing he saw was an over use of laxatives. Since I had never taken a laxative in my entire life, except for the liquid to clean me out for the test, I swore I would never have another colonoscopy.

I did end up having one when I was about 50 and this time it wasn’t nearly as bad, but I had insurance that paid for it.

Since the only insurance I have now is Medicare Parts A&B, I’m hesitant to have a colonoscopy, so I was pleased to find out that Medicare paid for me to have a Cologuard test. It was easy and according to reports, is fairly accurate in detecting colorectal cancer. One source says that Cologuard is detects about 95% of colorectal cancers.

My test came back negative.

Many doctors are recommending Cologuard for their older patients.

But, there is a down side to relying on Cologuard over a traditional colonoscopy.

Have you ever heard of polyps?

According to the Mayo Clinic:

“A colon polyp is a small clump of cells that forms on the lining of the colon. Most colon polyps are harmless. But over time, some colon polyps can develop into colon cancer, which is often fatal when found in its later stages.”

“There are two main categories of polyps, non-neoplastic and neoplastic. Non-neoplastic polyps include hyperplastic polyps, inflammatory polyps and hamartomatous polyps. These types of polyps typically do not become cancerous. Neoplastic polyps include adenomas and serrated types. In general, the larger a polyp, the greater the risk of cancer, especially with neoplastic polyps.’

“Anyone can develop colon polyps. You’re at higher risk if you’re 50 or older, are overweight or a smoker, or have a personal or family history of colon polyps or colon cancer.”

“Colon polyps often don’t cause symptoms. It’s important to have regular screening tests, such as a colonoscopy, because colon polyps found in the early stages can usually be removed safely and completely. The best prevention for colon cancer is regular screening for polyps.”

When polyps are found during a colonoscopy, they are usually and easily removed, thus reducing the chance of them developing into cancer. However, Cologuard only detects about 42% of precancerous polyps.

That means that relying on Cologuard does present a greater risk of eventually developing colorectal cancer than having a colonoscopy.

One doctor said that even with negative results from regular Cologuard tests, it is still recommended that people over 50 still have a periodic colonoscopy. They can see more and remove polys where Cologuard doesn’t.

As embarrassing and humiliating as a colonoscopy is, they are still a more reliable and preferred method of testing for colorectal cancer and can lower the risk of colorectal cancer by removing polyps, which Cologuard can’t.


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