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Cologuard

Cologuard; Colon cancer screening - Cologuard; Stool DNA test - Cologuard; FIT-DNA stool test; Colon precancer screening - Cologuard

Cologuard is a screening test for colon and rectal cancer.

The colon sheds cells from its lining every day. These cells pass with the stool through the colon. The cancer cells may have DNA changes in certain genes. Cologuard detects the altered DNA. The presence of abnormal cells or blood in the stool may indicate cancer or precancer tumors.

How the Test is Performed

The Cologuard testing kit for colon and rectal cancer must be ordered by your health care provider. It will be sent by mail to your address. You collect the sample at home and send it back to the lab for testing.

The Cologuard testing kit will contain a sample container, a tube, preserving liquid, labels, and instructions on how to collect the sample. When you are ready to have a bowel movement, use the Cologuard testing kit to collect your stool sample.

Read the instructions that come with the testing kit carefully. Wait until you are ready to have a bowel movement. Collect the sample only when it is possible to ship it within 24 hours. The sample must reach the lab in 72 hours (3 days).

DO NOT collect the sample if:

  • You have diarrhea.
  • You are menstruating.
  • You have rectal bleeding due to hemorrhoids.

Follow these steps to collect the sample:

  • Read all instructions that come with the kit.
  • Use the brackets provided with the testing kit to fix the sample container on your toilet seat.
  • Use the toilet as usual for your bowel movement.
  • Try not to let urine get into the sample container.
  • Do not put toilet paper into the sample container.
  • Once your bowel movement is over, remove the sample container from the brackets and keep it on a flat surface.
  • Follow instructions to collect a little sample in the tube provided with the testing kit.
  • Pour the preserving liquid in the sample container and close the lid tightly.
  • Label the tubes and the sample container according to the instructions, and place them in the box.
  • Store the box at room temperature, away from direct sunlight and heat.
  • Ship the box within 24 hours to the lab using the label provided.

The results of the test will be sent to your provider in two weeks.

How to Prepare for the Test

The Cologuard test does not require any preparation. You do not need to change your diet or medicines before the test.

How the Test will Feel

The test requires you to have a normal bowel movement. It will not feel any different from your regular bowel movements. You can collect the sample at your home privately.

Why the Test is Performed

The test is done to screen for colon and rectal cancer and abnormal growths (polyps) in the colon or rectum.

Your provider may suggest Cologuard testing once every 1 to 3 years after age 45 years. The test is recommended if you are between ages 45 to 75 years and have an average risk of colon cancer. This means that you do not have:

  • Personal history of colon polyps and colon cancer
  • Family history of colon cancer
  • Inflammatory bowel disease (Crohn disease, ulcerative colitis)

Normal Results

The normal result (negative result) will indicate that:

  • The test did not detect blood cells or altered DNA in your stool.
  • You do not need further testing for colon cancer if you have an average risk of colon or rectal cancer.

What Abnormal Results Mean

Abnormal result (positive result) suggests that the test found some pre-cancer or cancer cells in your stool sample. However, the Cologuard test does not diagnose cancer. You will need further tests to make a diagnosis of cancer. Your provider will likely suggest a colonoscopy.

Risks

There is no risk involved in taking the sample for Cologuard test.

Screening tests carry a small risk of:

  • False-positives (your test results are abnormal, but you do NOT have colon cancer or pre-malignant polyps)
  • False-negatives (your test is normal, even when you have colon cancer)

Considerations

It is unclear yet whether the use of Cologuard will lead to better outcomes compared with other methods used to screen for colon and rectal cancer.

Open References

References

Benson AB, Venook AP, Al-Hawary MM, et al, eds. Colon cancer, version 2.2021, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2021 2;19(3):329-359. PMID: 33724754. pubmed.ncbi.nlm.nih.gov/33724754/.

Bresalier RS. Colorectal cancer. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 127.

Eckmann JD, Ebner DW, Bering J, et al, eds. Multitarget stool DNA screening in clinical practice: high positive predictive value for colorectal neoplasia regardless of exposure to previous colonoscopy. Am J Gastroenterol. 2020;115(4):608-615. PMID: 32068535. pubmed.ncbi.nlm.nih.gov/32068535/.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published May 18, 2021. Accessed June 29, 2021.

  • Colon cancer

    Colon cancer

    Animation

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    Colon cancer - Animation

    Colon cancer may not be talked about as often as other cancers, like breast cancer, prostate or lung cancer, but it's actually one of the leading causes of cancer deaths. It is for this reason it's very important to stay on top of your colon health. The colon is your large intestine, the long, upside-down U-shaped tube that is toward the end of the line for getting rid of waste in your body. Colon cancer can start in the lining of the intestine, or at the end of it, called the rectum. Let's try to better understand Colon cancer. You're more likely to get the disease if you're over age 60, especially if you have a family history of colon cancer, inflammatory bowel disease, diabetes, or obesity. Smoking cigarettes and drinking alcohol has also been found to increase your risk of getting colon cancer. Although the data are not consistent, eating red meat or processed meats may increase the risks of colon cancer as well. Lean, unprocessed red meat, may be associated with less risk. If you have symptoms, they may include pain in your abdomen, blood in your stool, weight loss, or diarrhea. But hopefully, you'll get diagnosed before you have any symptoms, during a regular screening test like a colonoscopy or sigmoidoscopy. These tests use special instruments to see inside your colon and rectum to look for any cancerous or pre-cancerous growths, called polyps. If your doctor discovers that you do have colon cancer, unfortunately, you'll need to have a few more tests, including scans of your abdomen to find out whether the cancer has spread, and if so, where in your body it's located. So, how is colon cancer treated? That really depends on how aggressive your cancer is and how far it's spread, but usually colon cancer is removed with surgery, or killed with chemotherapy or radiation. You may get one, or a combination, of these treatments. Colon cancer is one of the more treatable cancers. You can be cured, especially if you catch it early. Spotting colon cancer when it's still treatable is up to you. If you're over age 45, you need to get screened. And, regular physical activity and eating at least some fruits and vegetables daily, perhaps with unprocessed wheat bran, can help prevent it. If you want to prevent colon cancer, you'll also want to avoid processed and charred red meats, and smoking, and excess calories, and alcohol.

  • Large intestine (colon)

    Large intestine (colon) - illustration

    The large intestine is the portion of the digestive system most responsible for absorption of water from the indigestible residue of food. The ileocecal valve of the ileum (small intestine) passes material into the large intestine at the cecum. Material passes through the ascending, transverse, descending and sigmoid portions of the colon, and finally into the rectum. From the rectum, the waste is expelled from the body.

    Large intestine (colon)

    illustration

  • Colon cancer

    Colon cancer

    Animation

    •  

    Colon cancer - Animation

    Colon cancer may not be talked about as often as other cancers, like breast cancer, prostate or lung cancer, but it's actually one of the leading causes of cancer deaths. It is for this reason it's very important to stay on top of your colon health. The colon is your large intestine, the long, upside-down U-shaped tube that is toward the end of the line for getting rid of waste in your body. Colon cancer can start in the lining of the intestine, or at the end of it, called the rectum. Let's try to better understand Colon cancer. You're more likely to get the disease if you're over age 60, especially if you have a family history of colon cancer, inflammatory bowel disease, diabetes, or obesity. Smoking cigarettes and drinking alcohol has also been found to increase your risk of getting colon cancer. Although the data are not consistent, eating red meat or processed meats may increase the risks of colon cancer as well. Lean, unprocessed red meat, may be associated with less risk. If you have symptoms, they may include pain in your abdomen, blood in your stool, weight loss, or diarrhea. But hopefully, you'll get diagnosed before you have any symptoms, during a regular screening test like a colonoscopy or sigmoidoscopy. These tests use special instruments to see inside your colon and rectum to look for any cancerous or pre-cancerous growths, called polyps. If your doctor discovers that you do have colon cancer, unfortunately, you'll need to have a few more tests, including scans of your abdomen to find out whether the cancer has spread, and if so, where in your body it's located. So, how is colon cancer treated? That really depends on how aggressive your cancer is and how far it's spread, but usually colon cancer is removed with surgery, or killed with chemotherapy or radiation. You may get one, or a combination, of these treatments. Colon cancer is one of the more treatable cancers. You can be cured, especially if you catch it early. Spotting colon cancer when it's still treatable is up to you. If you're over age 45, you need to get screened. And, regular physical activity and eating at least some fruits and vegetables daily, perhaps with unprocessed wheat bran, can help prevent it. If you want to prevent colon cancer, you'll also want to avoid processed and charred red meats, and smoking, and excess calories, and alcohol.

  • Large intestine (colon)

    Large intestine (colon) - illustration

    The large intestine is the portion of the digestive system most responsible for absorption of water from the indigestible residue of food. The ileocecal valve of the ileum (small intestine) passes material into the large intestine at the cecum. Material passes through the ascending, transverse, descending and sigmoid portions of the colon, and finally into the rectum. From the rectum, the waste is expelled from the body.

    Large intestine (colon)

    illustration

Tests for Cologuard

 
 

Review Date: 4/23/2021

Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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