{"id":6438,"date":"2014-10-26T17:12:15","date_gmt":"2014-10-26T22:12:15","guid":{"rendered":"https:\/\/wholehealthchicago.com\/?p=6438"},"modified":"2021-08-23T10:21:59","modified_gmt":"2021-08-23T15:21:59","slug":"no-more-colonoscopies-for-most-of-us","status":"publish","type":"post","link":"https:\/\/wholehealthchicago.com\/blog\/2014\/10\/26\/no-more-colonoscopies-for-most-of-us","title":{"rendered":"No More Colonoscopies! (For Most of Us)"},"content":{"rendered":"\n

If you\u2019re approaching 50, you\u2019re 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.<\/p>\n\n\n\n

Other topics perhaps you\u2019d 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.<\/p>\n\n\n\n

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\u2019s experiences, I\u2019d place the colonoscopy at easier than a root canal but more challenging than a paper cut or bad haircut.<\/p>\n\n\n\n

But now you can draw a line through (rather than under) \u201cget a colonoscopy\u201d on your list of after-50 tasks.<\/p>\n\n\n\n

Aren\u2019t you glad you lived to see this day?<\/p>\n\n\n\n

Cologuard approved<\/strong><\/h3>\n\n\n\n

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.<\/p>\n\n\n\n

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.<\/p>\n\n\n\n

If your Cologuard test result comes out positive, you\u2019ll obviously need an eyes-on colonoscopy to locate and eventually remove any problem areas. If negative, repeat the Cologuard a decade later.<\/p>\n\n\n\n

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\u2019re 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.<\/p>\n\n\n\n

No more cherry-flavored laxative<\/strong><\/h3>\n\n\n\n

Just think! With a Cologuard you\u2019ll miss drinking that quart of cloying laxative that turns your intestines into Mount St. Helens until they\u2019re clean enough to glow. You\u2019ll also avoid the endless back-and-forth to your toilet and that ride to the hospital with your pelvic floor muscles locked tight (\u201cHoney, please, do not hit another pothole!). You won\u2019t have to watch your large intestine being explored up there on the monitor, and you\u2019ll miss the cheery, \u201cYou\u2019re fine, no cancer,\u201d from your gastroenterologist. Finally, you\u2019ll sidestep the experience of passing more post-colonoscopy gas than you knew any human could hold.<\/p>\n\n\n\n

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\u2019s), 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.<\/p>\n\n\n\n

If you\u2019re curious about having the Cologuard test, especially if you\u2019re in that sizable group called \u201ccolonoscopy procrastinators,\u201d read more about it on their website<\/a>.<\/p>\n\n\n\n

Want to try the new test?<\/strong><\/h3>\n\n\n\n

If you want to proceed and you\u2019re 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\u2019re not a WHC patient, ask your primary care doctor for information.)<\/p>\n\n\n\n

Doctors\u2019 offices are not supplied with the test kits, just FYI.<\/p>\n\n\n\n

You\u2019ll 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.<\/p>\n\n\n\n

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.<\/p>\n\n\n\n

You mail the kit back to them, your test results will be sent to our office, and we\u2019ll contact you.<\/p>\n\n\n\n

Paying for Cologuard<\/strong><\/h3>\n\n\n\n

If you\u2019re at all familiar with the chicaneries of health insurance you know that \u201capproval\u201d is not the same as \u201cpayment.\u201d Cologuard will work to seek full payment (including filing appeals), and you\u2019ll receive in the mail an Explanation of Benefits from your insurer, with the reminder that \u201cThis is Not a Bill.\u201d<\/p>\n\n\n\n

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\u2019s efforts, the remaining portion becomes your responsibility. If you do get a bill, it may arrive months and months after your test is completed.<\/p>\n\n\n\n

Keep in mind that colon cancer is one of the most preventable and yet least prevented cancers in the US today. It\u2019s 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.<\/p>\n\n\n\n

Yet one in three adults over 50 still aren\u2019t getting screened as recommended. If you\u2019re in this group, let the Cologuard test change your world.<\/p>\n\n\n\n

I\u2019m doing my own this week. Yes, to be honest, I\u2019d rather be in Paris, or even the Dells, than busy collecting my specimen, but then again, I, too, want to\u2026<\/p>\n\n\n\n

Be well,
David Edelberg, MD<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

If you\u2019re approaching 50, you\u2019re 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. […]<\/p>\n","protected":false},"author":2087,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[352,2,14,50,3],"tags":[1684,935,383],"class_list":["post-6438","post","type-post","status-publish","format-standard","hentry","category-aging","category-blog","category-c","category-healthy-lifestyle","category-knowledge-base","tag-cologuard","tag-colon-cancer","tag-colonoscopy"],"yoast_head":"\r\nNo More Colonoscopies! 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