2265 North Clybourn Avenue    Chicago, IL 60614    P: 773.296.6700     F: 773.296.1131

No More Colonoscopies! (For Most of Us)

If you’re approaching 50, you’re facing issues unique to your next half century. Oh, sure, there are lots of good things to anticipate, like joining AARP for discounts on Depends or joining one of their affordable bus tours to the Dells. You can even fantasize about retirement, though it may be years and years away.

Other topics perhaps you’d just as soon not overthink: your mortality, for one. And perhaps budgeting a facelift, researching hormone replacement, scheduling mammograms, checking your IRA balance, wondering whether the Viagra sold online actually works, and, oh yes, your first colonoscopy.

With my own colonoscopy experience now behind me (so to speak), let me reassure colonoscopy virgins that the procedure is sort of anti-climactic, almost peaceful in its fashion. With 5.5 feet of fiberoptic tubing deep within my large intestine, I expected more drama. Among life’s experiences, I’d place the colonoscopy at easier than a root canal but more challenging than a paper cut or bad haircut.

But now you can draw a line through (rather than under) “get a colonoscopy” on your list of after-50 tasks.

Aren’t you glad you lived to see this day?

Cologuard approved
A couple weeks ago, the FDA approved a test called Cologuard, which uses DNA analysis of a stool specimen to screen you for colon cancer and pre-cancerous colon polyps. Moreover, because the test is quite a bit less expensive than a colonoscopy (in which both the gastroenterologist and the outpatient facility have to be paid), health insurance companies seem to be cooperating when it comes to paying for Cologuard.

The company that developed Cologuard, Exact Sciences, submitted data on 10,000 patients. When the test showed a diagnostic accuracy of 92% (about the same as a colonoscopy), the FDA was impressed.

If your Cologuard test result comes out positive, you’ll obviously need an eyes-on colonoscopy to locate and eventually remove any problem areas. If negative, repeat the Cologuard a decade later.

In rare cases, there are false-positive results (test is positive, follow-up colonoscopy is negative) as well as false-negatives (the test misses a cancer). Realize, though, that even a colonoscopy can miss a cancer. In this unnerving case, if you’re following the rules of getting an annual stool test for blood (part of a routine physical), any missed cancer will still be picked up early.

No more cherry-flavored laxative
Just think! With a Cologuard you’ll miss drinking that quart of cloying laxative that turns your intestines into Mount St. Helens until they’re clean enough to glow. You’ll also avoid the endless back-and-forth to your toilet and that ride to the hospital with your pelvic floor muscles locked tight (“Honey, please, do not hit another pothole!). You won’t have to watch your large intestine being explored up there on the monitor, and you’ll miss the cheery, “You’re fine, no cancer,” from your gastroenterologist. Finally, you’ll sidestep the experience of passing more post-colonoscopy gas than you knew any human could hold.

The test was devised for people over 50 at average risk. There are a few people for whom the Cologuard test is not advised, primarily those with a greater-than-average risk for developing colon cancer. These include patients with inflammatory bowel disease (ulcerative colitis and Crohn’s), previous colon cancers, and certain genetic susceptibilities to colon cancer. You also cannot have had recent large-intestine issues like diarrhea or rectal bleeding (hemorrhoids, fissures). Menstruating women should do the test between periods, since a little menstrual blood inadvertently mixed with stool can lead to a false-positive result.

If you’re curious about having the Cologuard test, especially if you’re in that sizable group called “colonoscopy procrastinators,” read more about it on their website.

Want to try the new test?
If you want to proceed and you’re a WholeHealth Chicago patient, call and schedule lab-only, and please bring your insurance card. This visit is mainly for paperwork, but requires your signature and thus cannot be done online. Our staff will complete the form, copy your card, and fax everything to the people at Cologuard. (If you’re not a WHC patient, ask your primary care doctor for information.)

Doctors’ offices are not supplied with the test kits, just FYI.

You’ll next receive a call from a Cologuard representative who will review your insurance and may, depending of your insurance company, ask you to pay a $50 advance to cover the kit, shipping charges, and the time spent getting prior authorization for insurance approval. This charge does not apply to Medicare patients since Medicare recently fully approved this test.

Once coverage is approved Cologuard will mail you the kit, complete with collection instructions vaguely reminiscent of Mr. Hanky, the Christmas poo character from South Park.

You mail the kit back to them, your test results will be sent to our office, and we’ll contact you.

Paying for Cologuard
If you’re at all familiar with the chicaneries of health insurance you know that “approval” is not the same as “payment.” Cologuard will work to seek full payment (including filing appeals), and you’ll receive in the mail an Explanation of Benefits from your insurer, with the reminder that “This is Not a Bill.”

When all is said and done, like just about everything in health care reimbursement, if your insurer does not pay the full balance after Cologuard’s efforts, the remaining portion becomes your responsibility. If you do get a bill, it may arrive months and months after your test is completed.

Keep in mind that colon cancer is one of the most preventable and yet least prevented cancers in the US today. It’s the third most diagnosed cancer, the second leading cause of cancer deaths in both sexes over 50, and one of the most treatable cancers if found early through a screening test.

Yet one in three adults over 50 still aren’t getting screened as recommended. If you’re in this group, let the Cologuard test change your world.

I’m doing my own this week. Yes, to be honest, I’d rather be in Paris, or even the Dells, than busy collecting my specimen, but then again, I, too, want to…

Be well,
David Edelberg, MD







Leave a Comment

  1. Eileen Mackey says:

    Dr. Edelberg, you crack me up! Only you would add South Park references to a post about colon cancer screenings. In all seriousness though, as a woman in her 30’s whose big sister’s gastrointerologist insisted! that she tell all of us younger siblings we needed to be screened starting at 45, not 50, I’m very pleased to hear about this new test! No offense intended at all, Dr. E, I love you much, but we see each other plenty as is.

  2. Robert Radycki says:

    WOW! I’m NOT shooting this messenger! I lost my colon virginity last year as I was a 65 year old chicken and procrastinator. I’d rather still be a virgin but that is all BEHIND me. (Pardon the pun) Thanks so much for this article and I absolutely LOVE your sense of humor especially on such a sticky subject. Also, thanks for reminding me about getting an annual checkup.

  3. bill says:

    Thanks for this encouragement to get checked out. I’m sure many of us know someone whose life has been saved by a colonoscopy which discovered a pre-cancerous polyp. That happened to me at age 40, to my Dad in his 70’s. His Dad, my grandad, died of colon cancer at age 59.

    One question: do you recommend this test for individuals like me who’ve already had at least one pre-cancerous polyp removed or should we get a colonoscopy every 5 years or so?

    thanks, Dr E!


  4. Dr E says:

    Hi Bill

    It’s a colonoscopy for you

  5. Ann Raven says:

    Mr. Hanky, not just for Christmas anymore!

  6. Arian Ward says:

    I’ve had digestive problems almost all my life, especially in my colon. Diagnosed with ulcerative colitis at age 15. Had it most of my adult life (except during my 20’s when I was smoking and leading a decadent lifestyle, it went into remission – something about nicotine’s effect on the colitis, but decades later nicotine patches didn’t have the same effect). Generally, 10+ years of continuous inflammation of most cells greatly increases the risk it will develop into cancer…..

    So, sure enough, diagnosed with colon cell dyplasia in my 40’s and cancer at age 50. So I had my colon removed. The reason for the story is to provide background for my recommendation coming from someone who has had too many colonoscopies + a colon cancer survivor (no recurrence in these 14 years since my operation 🙂 Plus I learned a lot when doing consulting work with the professional society for endoscopists….

    My recommendation: I don’t think people should stop all colonoscopies just because of this test. Why? Polyps often develop in the colon that have no dysplastic cells yet – no pre-cancer. Yet those polyps are one of the most likely places in the colon to develop cancer later. A colonoscopy always involves removing all polyps, so the colonoscopy isn’t only diagnostic, it’s preventative. Because colon cancer is one of the slowest growing cancers, I think the safest route to take is get a colonoscopy every 5-7 years after age 45 and to screen for cancer every 2 years in between those. Why would you want to wait until the cells begin to mutate in one or more polyps to do anything, when you can remove them as a potential cancer hot spot?

  7. Arian Ward says:

    My recommended years between colonoscopies & Cologuard tests is a bit of a guess. A gastroenterologist would be best able to give you the safest, but also most cost effective interval between the different types of tests, GE’s are the specialists who do colonoscopies, ERCP’s (running a scope into your digestive system from the other end – down your throat, but you’re put all the way under for this or your gag reflex goes into high gear), and newer non-intrusive scoping using a small swallowed capsule containing a wireless camera they use to observe and record the entire journey through your digestive system. It could be more years than I said between each type of diagnostic. My key point isn’t the interval – its to still get an occasional colonoscopy to remove polyps to prevent them from ever becoming cancerous!

  8. Arian Ward says:

    I shouldn’t be posting comments at 3 am 🙂 Did I get the name of the specialist wrong on my last post? It was supposed to be gastroendoscopist but I’m not sure if that’s what my tired mind communicated. Please correct if wrong and delete this comment. Thanks for your excellent site!

  9. B. Gail Mendenhall says:

    This is great news! I’m 63 and scheduled for my colonoscopy this week, as it’s been ten years since the last one and my doctor recommended another one at the time of my physical.
    I will be sure and save this article and ask for cologuard in the future. I do not live in Chicago area any longer. I’m now in Columbus, Ohio.
    Thanks for the information!
    I look forward to your newsletters, and wish I was still a patient at WHC!

  10. Rita Hernandez says:

    Dr. Edelberg,
    Greetings, it has been awhile since we seen each other (fellow Navy Pier U of I alum) since I have moved to Texas and don’t frequent Whole Health on a regular basis. Although, I will say I continue to order products/supplements from WHC.
    My reason for writing is because we share another commonality: tomorrow I am getting my colonoscopy, not doing the Cologuard–at least, this time. Hopefully, we will both be fine on that score and all will “come out well” (so to speak). Peace, Rita D. Hernandez, Ph.D.

  11. Dale says:

    Great info!!!

  12. Colleen Jersild says:

    I did the Cologuard test and the results came back that there was a 4% chance that I have cancer and a 20% chance that I have a pre-cancerous plyop. They recommended a full colonscopy. That was attempted and failed. Apparently I have a narrow angular colon and they could not get the equipment in me. A virtual colonscopy is not recommended for people with a history of colon cancer in the family and/or a history of diverticulitis and I have both. Is there any other way of imaging the colon, and if a pre-cancerous plyop is found, how can it be removed? Surely I can’t be the only person in the country with this problem.

  13. Dr E says:

    Hi Colleen
    There are imaging techniques, like a PET-CT scan. that diagnose polyps and cancers. You could talk to your gastroenterologist about this

  14. James Altieri says:

    Do i still need a colonoscopy after my cologaurd test came back negative in july 2018 ?

    • Dr. R says:

      Hi James. No need for a colonoscopy after a negative Cologuard test last month unless you have a strong family history of digestive tract (colon) cancer. Always best to check with your primary care physician as well.

Join our Newsletter

Get health recommendations, delicious and time-saving recipes, medical news, supplement reviews, birthday discounts, and more!

Health Tips

Dr. Edelberg’s Health Tips contain concise bits of advice, medical news, nutritional supplement and pharmaceutical updates, and stress relief ideas. With every Health Tip, you’ll also receive an easy, delicious, and healthful recipe.

When you sign up to receive Health Tips, you can look forward to Dr. Edelberg’s smart and very current observations arriving in your in-box weekly. They’re packed with helpful information and are often slightly irreverent. One of the most common responses to the tips is “I wish my doctor talked to me like this!”

Quick Connect

Get One Click Access to our


The Knowledge Base

Patient education is an integral part of our practice. Here you will find a comprehensive collection of staff articles, descriptions of therapies and nutritional supplements, information addressing your health concerns, and the latest research on nutritional supplements and alternative therapies.

Telemedicine – Now Available at WholeHealth Chicago

In order to maintain your continuity of care, WholeHealth Chicago now offers telemedicine appointments with most of our practitioners. During a telemedicine visit, you and your healthcare provider can review medical history, discuss symptoms, arrange for prescriptions, and more. When necessary, labs and diagnostic imaging can be ordered from a facility near your home, and our Natural Apothecary can ship supplements quickly to your door.

Please contact Patient Services for details and scheduling a telemedicine appointment, or to change a regular appointment to telemedicine by calling 773-296-6700.

We’re looking forward to meeting with you in our virtual consultation room soon.


Far and away, the commonest phone call/e mail I receive asks about COVID-19 diagnosis.
Just print this out, tape it on your refrigerator door, and stay calm.


• Runny nose
• Sneezing
• Red, swollen eyes
• Itchy eyes and nose
• Tickly throat
• No fever

• Runny nose
• Sneezing
• Sore throat
• Mild muscle aches
• Mild dry cough
• Rarely a low fever

• Painful sore throat
• Hurts to swallow
• Swollen glands in neck
• Fever

FLU (Standard seasonal flu)
• Fever
• Dry cough (no mucus)
• Sudden onset over few hours
• Headache
• Sore throat
• Fatigue, sometimes quite severe
• Muscle aches, sometimes quite severe
• Rarely, diarrhea

• Shortness of breath
• Fever (usually above 100 degrees)
• Dry cough (no mucus)
• Slow onset (2-14 days)
• Mild muscle aches
• Mild fatigue
• Mild sneezing

Recent Health Tips

  • Commonly Missed Diagnosis: Early Autoimmune Disease

    Amazingly enough, there are more than 100 different autoimmune conditions, which collectively are responsible for more chronic illness and disability in women than heart disease and cancer combined. Men can get autoimmune diseases too, but the predominance in women (2:1) is striking and also puzzling, though current thinking attributes this susceptibility to a combination of genes and hormones. Because autoimmune conditions can affect any area Read More

  • Six Commonly Missed Diagnoses: B12 Deficiency

    You’re pretty sure you know your body and you tell your doctor you’re just not feeling right. You’re tired, maybe a little depressed, a bit achy. Maybe your digestion is “off.” The list of foods you can’t seem to enjoy is definitely longer. Your doctor’s empathic, not at all dismissive of your symptoms, but after a physical exam and some apparently appropriate tests she can’t Read More

  • What is Low-Dose Naltrexone (LDN) and Can It Help Me?

    Ten years ago April marks the anniversary of the first time I wrote about low-dose naltrexone (LDN). I described it as an orphan drug, meaning that its patent had long ago expired, that it was generic, and that it was not owned by any one company. For these reasons and because they’d never recoup their investment, no Big Pharma company was interested in pursuing the Read More

Join our Discount Program

Member benefits include 10% off all your purchases. Low, one-time membership fee of $25 ($35 for family).


Join our Newsletter

Get health recommendations, recipes, medical news, supplement reviews, birthday discounts, and more!