What Is Cologuard?

Have you heard about Cologuard, wondering what it is or if it can replace a routine colonoscopy?

Cologuard is a fairly new test designed to detect precancerous cells in the colon and rectum.  It is a prescription only test so you must see a doctor to obtain the prescription before you can obtain your test kit.

Cologuard Collection Kit

Once ordered the Cologuard Collection Kit will ship to your home. You collect a stool sample and send the kit back to a lab.  It is then analyzed and the results sent to your doctor.  If positive DNA is identified your doctor contacts you to discuss the results and recommended next steps.

Sounds easy enough and more convenient than a colonoscopy. But is it?

Colon Polyp
Colon polyps can lead to cancer later.

This is still a new relatively technology and we are evaluating who might be a candidate for Cologuard and the potential benefits, especially for low-risk patients.  Even so, we are not recommending Cologuard be used as an alternative to a routine colonoscopy.

Colonoscopy Vs. Cologuard


During a colonoscopy we use advanced technology including a small camera to look for possible issues, like polyps, which can lead to cancer later.  If your CRS surgeon identifies polyps they are removed during the colonoscopy vs. scheduling a follow-up appointment to come back for another procedure.


Cologuard tests stool samples in a lab, but cannot actually see inside the patient’s colon or rectum.  If the test detects DNA indicating cancerous or pre-cancerous cells the recommended next step is a follow-up colonoscopy.

While we do recognize that many medical tests have a degree of error, the Cologuard website notes “The test can also have a negative result that is incorrect (false negative). This means the test result missed potential cancer or precancer. For that reason, it is recommended that you schedule regular screenings.” 

If a regular colonoscopy screening is recommended in addition to the Cologuard test, the convenience of taking the test at home seems greatly diminished by the recommended additional appointments and out of pocket costs.

How Much Does Cologuard Cost?

Cologuard has a maximum out of pocket cost of $649 not including co-pays and lab fees.  Some insurance companies are now covering a portion of cost but it is not yet recognized as a critical screening tool, like the colonoscopy, which is widely covered by insurance plans.

Who Is Cologuard Designed For?

Cologuard was designed for low-risk patients.  Those without a personal or family history of colon cancer or polyps, or patients who had a positive screening test within the past 6 months.  It is also not recommended for anyone who has blood in the stool including blood due to hemorrhoids.

CRS Recommendation About Cologuard

While we aren’t saying this isn’t going to help in the fight against colon cancer, we aren’t ready to recommend this test in lieu of a colonoscopy or suggest patients take on an extra out of pocket cost to get the test done in addition to a colonoscopy.

As with most technology, advances are continually changing and thus our recommendation may change. CRS is dedicated to providing all patients with the highest quality care and education needed for the treatment of colon and rectal problems.

We routinely review advances in the field of colon health and cancer prevention and may add updates on this topic in the future.

Get a Colon Screening in Richmond, Virginia

Wondering what colon cancer screening test is right for you?  Contact our one of our three Richmond area offices.  Our colon and rectal specialists can review your personal medical history and provide a recommendation.

Contact Colon & Rectal Specialists