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Date: 5/12/2016
GREATER?SPRINGFIELD – For many who dread that mid-life rite of passage – the colonoscopy – there’s now an alternative. Cologuard offers patients with no contributing factors to potential colon cancer a no-prep test that can be done in the privacy of their homes.
“Cologuard is non-invasive, an easy test,” explained Internist Dr. Sheldon Lyons with Mercy Medical Group, (formerly Hampden County Physician Associates) in East Longmeadow. “The company sends a kit to the house, patients collect one bowel movement sample and send it in to the lab for testing.”
Once returned to the lab in the prepaid shipping container, Lyons said the sample is examined for signs of hidden blood and DNA in the stool, two potential markers for colon cancer. A negative result, Lyons said, “is reasonably reassuring that they do not have colon cancer or cancerous polyps.” A positive result means the patient should move forward with scheduling a regular colonoscopy to determine if cancer or a pre-cancerous condition is present in the bowel. Cologuard is the first FDA-approved noninvasive test on the market that uses DNA screening to look for signs of cancer.
However, “Cologuard is not the gold standard for colon cancer screening,” Lyons cautioned. “It is not a test that is recommended for high-risk patients who have had previous colon cancer or precancerous polyps or a family history of colon cancer.
“But for people who are at intermediate risk who absolutely refuse to have a colonoscopy – which many people do – it is the second best test,” he added.
Lyons said physicians have been able to provide patients with a prescription for Cologuard for about 18 months, and that many insurance providers, including Medicare, Medicaid, Aetna Medicare Advantage, Blue Cross Blue Shield of both Massachusetts and Rhode Island, and Tufts Health Plan, now cover the test.
“I was onboard early [with Cologuard],” Lyons said. “I prefer patients have a colonoscopy or do the [three-sample] stool test cards, but at least you are giving them a test.”
To date he estimates about 100 of his patients have used Cologuard, with most receiving negative results.
“We had about 10 positives and I know of one person who was diagnosed with colon cancer, but it was caught reasonably early,” he said, with the other positives resulting in several patients being diagnosed with polyps through further testing.
Though he prefers to see patients undergo the traditional colonoscopy, Lyons said he sees Cologuard – which he believes may be on the forefront of the use of DNA testing as a diagnostic – as a reasonable alternative.
“Many people will refuse to take the time [for a colonoscopy] or they’re scared of the drink or they’re scared they can have a rare, rare bowel perforation or reaction to the sedation,” Lyons said. “Recently there was a problem at Noble [Hospital in Westfield] with the sterilization of gastroenterology equipment and a number of people have refused colonoscopies because of that fear now.
“The only risk [with Cologuard] is a false positive,” he continued. “In that way there is no chance of getting an infection or getting a bad reaction or anything else.”
Lyons said Cologuard can be prescribed by primary care, internists and gastroenterologists. For a listing of local providers, and more information about Cologuard, visit www.cologuardtest.com.
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