A matter of convenience, money

SAN ANTONIO – Many people postponed all kinds of medical screenings during the COVID-19 pandemic. And while all medical tests are important, colon cancer screening requires you to think carefully about how you’re doing it.

The wrong choice can add pain to your wallet or possibly even force you to overlook a diagnosis.

The choice between tests is wide, but some gastroenterologists want to make sure you know what you’re signing up for, both medically and financially. As we mark colon cancer awareness month, you may be reminded that it is time to make that choice.

The screening test, Cologuard, is popular for a number of reasons. Cologuard is a relatively inexpensive home screening test that checks for DNA and blood abnormalities that indicate possible cancer growth. It doesn’t require a colonoscopy pretreatment, which means there are no nasty Koolaid-tasting things to choke on to clean your colon or fast the day before.

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The problem is, if you really need accuracy, this isn’t the best choice.

Dr. Peresh Mehta, of Gastroenterology Consultants of San Antonio, wants to make sure that people with a family history of colon cancer or gastro complications know the limitations.

“That test is about 70% good at finding cancer, but it’s only about 20% at finding the large polyps, which are usually precancerous, and those are the ones that you really want to get rid of with a colonoscopy,” Mehta said. .

In contrast, a full colonoscopy is 95% accurate in locating large polyps, which can be biopsied and sent to a lab for full analysis.

If a Cologuard test indicates the presence of polyps, you probably now also need a colonoscopy. That’s where the financial issue comes in. Many insurance companies only cover the initial screening.

‘They just say,’ You have one screening, one mammogram, one Pap smear, one colon screening, so if you use it, you’re out of luck. Now you have to pay, ” said Mehta.

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Cologuard is also intended for people with an average risk of colorectal cancer and who do not have problems such as IBD or a family history of colorectal cancer.

“The best thing to do is colonoscopy. There is no doubt. No one questions that when done right. You’re very protected, about as best you can be protected from any cancer, ”said Mehta.

According to the Cologuard website, more than 95% of patients nationwide pay no out-of-pocket expenses, based on eligible patients aged 50-75 who are at an average risk of colon cancer and have no symptoms. Cologuard is covered by Medicare and Medicare Advantage with no copay or deductible for eligible patients aged 50 to 85.

The website does advise patients to know the insurance requirements for a positive result in colon cancer.