ColoGuard - Breakthrough or Not?

Learn how to predict & prevent heart attack & stroke:

Learn how to reduce & reverse arterial plaque:
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ABOUT THIS VIDEO:

This fDNA test was much anticipated. Instead of looking simply for blood from a polyp, this was a test for the adenoma or cancer DNA. It actually could have worked better. The sensitivity is improved over other at-home colon cancer tests.

However, the price is over $600 each time. At that price, no one's likely to do repeated studies. They're only recommended every 3 years. Even at that 3-year interval, it's still over $1,000 over a 10-year period.

That's why very few standards, guidelines, or recommendations include fDNA (Cologuard) as a front-line option. They've just priced themselves out of being a practical option.
Adding other testing technology improves the sensitivity but at great cost for increased false-positive tests.
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ABOUT DR. BREWER
Dr. Brewer started as an Emergency Doctor. After seeing too many preventable heart attacks, he went to Johns Hopkins to learn Preventive Medicine. While there, he went on the run the post-graduate training program (residency) in Preventive Medicine. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has close to 1,000 primary care/prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, and stroke prevention clinic.

At PrevMed, we focus on heart attack, stroke, and cognitive decline. We serve patients who have already experienced an event as well as those who have not developed a diagnosis or event. Dr. Brewer provides services via telemedicine or in person if you're in the Lexington, KY area. We find a lot of undiagnosed prediabetes or insulin resistance. Treating unrecognized risk factors like prediabetes allows reduction of risk and prevention of disease.

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[Jack-mirk]

I don’t trust Doctors anymore or pharmaceutical companies they don’t care about anything but money it’s a shame it’s come to this in America it’s the same with our government !

[LThill-ksuz]

I just read that insurance won't cover the colonoscopy if you have a positive cologuard test, why is that? It shouldn't matter. I hate the anxiety I'm going trough waiting for the colonoscopy, it was cancelled just days before because the facility doesn't take medicare. They waited over a month to tell me this, and now have to wait yet another month. I have a positive cologuard test and I'm anxious to know if it's true.
There seems to be no corn for my well being, just dollars.
By the way, I first had to wait a month for a "consultation", I spent 5 minutes with him and they charged $300. I mistrust doctors and healthcare overall.

[mrtcward]

Not a breakthrough. Don’t do it. I had a positive test that caused me to have a normal colonoscopy. It was negative. Just go straight to the colonoscopy. A money pit in my opinion.

[carlpahnke]

Hey Doc, why do you continue to delete my comments? I'll put up a few facts again just to help you inform the public-after all isn't that what you want to do as a Dr., help people? Cologuard was developed with the guidance of the Mayo Clinic, one of the most respected healthcare organizations on the planet.
Cologuard was unanimously approved by the FDA in 2014 with some panelists saying it's the greatest screening test to come along in 25 years.
Cologuard was given an "A" rating by the USPSTF which is the same as colonoscopy.
Cologuard detects 94% of stage 1 and 2 cancers, the same as colonoscopy.
Cologuard does detect polyps.
Cologuard requires no prep or change to diet or medications.
Cologuard has zero risk of harms due to prep. sedation or the scope itself such as infections due to non-sterile instruments, or even a perforated bowel which about 1 in 500 patients will suffer.
Cologuard is done from home and you miss no work or time away from other activities.
Cologuard is done at home with no risk of contracting other diseases or viruses such as the Corona virus or the Flu.
Cologuard is covered by Medicare and currently 95% of patients 50 and over are covered fully with no out of pocket costs.
Cologuard is approved for patients 45 years of age and up (70% of patients 45-49 currently pay nothing for the test)
Cologuard keeps over 80% of patients from needing an invasive and expensive colonoscopy.
Cologuard patients are more likely to survive a miss of cancer due to the 3-year screening interval. Cologuard has no chance to harm a disease-free patient.
Cologuard finds cancer at the same rate regardless of location in the bowel (colonoscopies have difficulty on the right side and miss more issues there).
Cologuard accuracy is not influenced by the patient or Doctors ability or distractions of the day.
Cologuard compliance is nearly 70%.
Cologuard list price is $649 (which nearly no patient pays list) and insurance companies are contracted much cheaper prices with Medicare paying $508.
Cologuard uses DNA-the latest in technology (and FIT).
Cologuard is getting millions of patients screened for colon cancer.
Cologuard is becoming the standard of care (gold standard) for routine screening.

Colonoscopy requires a signature from the patient releasing all liabilities of possible harms by the Dr. anesthesiologist and hospital
Colonoscopy requires a thorough prep. by the patient in order for the Dr to provide a very thorough scope.
Colonoscopy accuracy is as low as 89% and is Dr. and patient dependent.
Colonoscopy screening interval is 10 years-therefore cancers missed will likely be in late stage before being checked again.
Colonoscopies done following a positive Cologuard test result in 48% more time spent and many more polyps, adenomas and lesions found.
Colonoscopy compliance is less than 50%
Colonoscopy costs many times more than Cologuard.
Colonoscopy is an invasive procedure and has a risk of serious harms to the patient.
Colonoscopy has been available for decades and still over 50, 000 people in the US die each year due to colon cancer.
Colonoscopy is a CASH COW for GI doctors and hospitals.
Colonoscopy WAS the "gold standard" for years as there was not a better way to be screened.

[carlpahnke]

With many of us "sheltering at home" now is the perfect time to be screened with Cologuard if you are 45 or older. Cologuard detects 94% of stage 1 and 2 cancers which is the same as colonoscopy but does so with no risk's. Please see some comparisons in my comment below. thanks!

[dmmcmah]

Idea for a future video - the relationship between the causes of colon cancer and heart disease. There are some indications they are the same. I did a quick search and found some papers suggesting people with colon cancer are more likely to have heart attacks and vice versa. There has also been a lot of research into hsCRP in colon cancer patients - some studies find significantly elevated hsCRP although at this point the research is inconclusive. The tip-off is that baby aspirin use reduces the risk of colon cancer.

[kathybrady]

Hi Dr. Brewer, very interesting. As a patient, when I received colorguard, it was at no cost to me as my insurance paid it. Also I believe that colonoscopy is almost $2000 in my region and I had a several hundred dollar co-pay . In addition, insurance won’t pay for a colonoscopy more than every 5 to 7 years whereas it sounds like cologuard may be covered twice as often.
Also, as a high risk patient I am fine with false positives because all that does is lead to a colonoscopy, which you rightly point out is the gold standard. Therefore I think my strategy of doing frequent Cologuqrds even if I pay $700 intermittently, as I cannot risk being permanently injured by anesthesia overdose.
Finally until recently at my job I was paid a daily rate. Therefore doing a colonoscopy cost me personally two days pay.
I agree however that the best test is the one that people are willing to do. But give your expertise I would greatly appreciate a piece on the dangers and risks of colonoscopy as it is the most invasive of all the tests and has to be repeated fairly frequently particularly if one starts at age 40, I would have nine colonoscopies by the time I am 80. If I never develop a polyp, I can have a lifetime of negative Cologuards and save myself 18 days of bowel prep and invasive instrumentation, possible infection, perforqtion, bleeding etc etc which are all impossible by evacuating into a plastic container and putting it into the mail lol!! 😀

[carlpahnke]

There are no routine screening colonoscopies being performed due to the Corona virus. However you can and should still be screened during this time. Please see my comment below listing the reasons Cologuard should be the first choice in colon cancer screening. After all, Doctors use CT scans and x-rays before any other surgery and colonoscopy is an invasive procedure done in a surgical suite.

[SawmillerSmith]

You said 50, 000 people die from colon cancer every year. I was thinking I wonder how many people die from overeating which causes obesity which causes other health problems. I wonder how many people die from overeating every year? Now that would seem to be simple to cure, is because all you would have to do is eat less.

[goming]

Because I don't have a family history of colon cancer, I just did a Cologuard test, and the result was negative.

[MissChrissyM]

My Cologuard kit has been sitting in my room for so many months.
It expires in August. Been procrastinating but now with these
Videos I’m ready.

[robrae]

After watching all 7 of these I still don’t want to get a colonoscopy. 😩

[footkinetics]

What happened to the video which was to follow this one... the video on the " Rogue Herpes Vaccine Trial"? I'm getting a message stating that it is unavailable... was it deleted?

[akanecortich]

Now if they came up with a little 'home' camera to swallow that you could watch on a monitor or record....that would be better.

[frankenz]

Sedation in a colonoscopy? V.A. doesn't put you under. They say they can't afford the help to turn you over or re-position you so you stay awake and watch it all. Looks like nothing more than ribbed plumbing to me anyways. I got to watch them do a liver biopsy as well once upon a time. I've had many colonoscopies because I had some variation of combined symptoms of UC and Crohn's disease for years with my Seronegative spondyloarthropathies. Enteropathic arthritis. So glad the last 2 scope exams have come out completely normal as all that went away. Up to only taking them every 5 years instead of annually as it had been during active years. It all takes some courage.

[RightToSelfDefense]

i am not all that impressed with "Exact Sciences" DNA fecal test.
I have the fecal smear test every year and have gotten no indicators of cancer.
I have no history of cancer in my family.
Just heart attacks and strokes.

I recently did the Cologuard test per my Doctor's request.

Sent the sample through UPS and got the results about a week later.
My regular physician got test results back and said that I
had an "80% chance of having colon cancer".
80%.
So he ordered a Colonoscopy.
Since my BMI was a little too high, I had to have this procedure done
in a hospital under anesthesia( instead of a clinic) with a $100 co-pay.

The bowel cleansing was the worse part of it. ($75 for the kit).

They performed the colonoscopy and found and removed a few
polyps.
No big deal. I've had nasal surgery twice to remove
nasal polyps due to reactions to allergens.

They saw no apparent cancer and the biopsy showed that I
had NO CANCER. Yea.

So what is this about having an 80% chance of having cancer?

I am not all that impressed with "Exact Sciences".
Not too exact to me.