Cologuard is "just OK"
Monday, May 27, 2019
In response to Dr. Cook’s Public Forum submission on May 19, I agree with the need for greater price and coverage transparency from medical insurance companies. I do hope that someday soon we achieve that goal.
However, as a gastroenterologist (GI specialist), I was taken aback at your inadvertent promotion of the Cologuard colon cancer screening test. This is not equivalent to a colonoscopy, and in my mind provides a false sense of security for those with a negative result. (And yes, it is not covered by all insurance companies).
Cologuard is a commercial product that tests for abnormal DNA in the stool. My office was one of the testing sites for this technology. The TV ads proclaim “Get, Go, Gone” as the convenient alternative for “low risk patient” colon cancer screening. It is a neat concept but it misses the point: This is really as test for colon cancer. Their data shows it misses over 30 percent of the serious pre-cancerous polyps. It even misses 9 percent of the cancers! That is not acceptable. This is an example of new technology taking us three steps back!
I don’t want my patients waiting until they develop colon cancer. The idea is to detect the pre-cancerous polyps before they become cancerous. Colonoscopy remains the “gold standard” as it has the highest rate of polyp and cancer detection. This means it is more likely to detect a cancer or polyp than any other test. And isn’t that our goal? An auto insurer ad states “don’t settle for okay.” The Cologuard test is "just OK.” You deserve better.
Thomas Ruffolo, MD
Dr. Ruffolo practices at Vidant Gastroenterology in Washington, N.C.