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Colorectal Cancer Screening: Overcoming Patient Barriers with a Noninvasive Screening Method

Program Information
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Program Information

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What do the guidelines recommend for the screening of patients at risk of CRC, and are there any barriers preventing screening?

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Important Risk Information.

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  • Overview

    As the prevalence of colorectal cancer (CRC) grows, clinical guidelines continue to change. What do they recommend for screening? Joining Dr. Charles Turck to answer that question and explore barriers to screening is Dr. Lanre Jimoh.

    © 2022 Exact Sciences Corporation. All rights reserved.
    M-US-CG-03447 October 2022
  • Indications

    Cologuard Indications for Use

    Cologuard® is intended for the qualitative detection of colorectal neoplasia associated DNA markers and for the presence of occult hemoglobin in human stool. A positive result may indicate the presence of colorectal cancer (CRC) or advanced adenoma (AA) and should be followed by colonoscopy. Cologuard is indicated to screen adults of either sex, 45 years or older, who are at typical average risk for CRC. Cologuard is not a replacement for diagnostic colonoscopy or surveillance colonoscopy in high-risk individuals.

  • Important Risk Information

    Cologuard Contraindications

    • Cologuard is intended for use with patients, age 45 years and older, at average risk who are typical candidates for CRC screening. Cologuard was not clinically evaluated for the following types of patients:
      • Patients with a history of colorectal cancer, adenomas, or other related cancers.
      • Patients who have had a positive result from another colorectal cancer screening method within the last 6 months.
      • Patients who have been diagnosed with a condition that is associated with high risk of colorectal cancer. These include but are not limited to:
        • Inflammatory Bowel Disease (IBD)
        • Chronic ulcerative colitis (CUC)
        • Chron’s disease
        • Familial adenomatous polyposis (FAP)
        • Family history of colorectal cancer
    • Patients who have been diagnosed with a relevant familial (hereditary) cancer syndrome, such as Hereditary non-polyposis colorectal cancer syndrome (HNPCC or Lynch Syndrome), Peutz-Jeghers Syndrome, MYH-Associated Polyposis (MAP), Gardner’s syndrome, Turcot’s (or Crail’s) syndrome, Cowden’s syndrome, Juvenile Polyposis, Cronkhite-Canada syndrome, Neurofibromatosis, or Familial Hyperplastic Polyposis.

    Warnings and Precautions 

    The performance of Cologuard has been established in a cross-sectional study (i.e., single point in time). Programmatic performance of Cologuard (i.e., benefits and risks with repeated testing over an established period of time) has not been studied. Performance has not been evaluated in adults who have been previously tested with Cologuard. Non-inferiority or superiority of Cologuard programmatic sensitivity as compared to other recommended screening methods for CRC and AA has not been established. 

    The clinical validation study was conducted in patients 50 years of age and older. ACS Guidelines recommend screening begin at age 45. Cologuard performance in patients ages 45-49 was estimated by sub-group analysis of near-age groups. 

    CRC screening guideline recommendations vary for persons over the age of 75. The decision to screen persons over the age of 75 should be made on an individualized basis in consultation with a healthcare provider. Cologuard test results should be interpreted with caution in older patients as the rate of false positive results increases with age. 

    A negative Cologuard test result does not guarantee absence of cancer or advanced adenoma. Patients with a negative Cologuard test result should be advised to continue participating in a colorectal cancer screening program with another recommended screening method. The screening interval for this follow-up has not been established.

    Cologuard may produce false negative or false positive results. A false positive result occurs when Cologuard produces a positive result, even though a colonoscopy will not find cancer or precancerous polyps. A false negative result occurs when Cologuard does not detect a precancerous polyp or colorectal cancer even when a colonoscopy identifies the positive result. 

    Patients should not provide a sample for Cologuard if they have diarrhea or if they have blood in their urine or stool (e.g., from bleeding hemorrhoids, bleeding cuts or wounds on their hands, rectal bleeding, or menstruation). 

    To ensure the integrity of the sample, the laboratory must receive the patient specimen within 96 hours of collection. Initiate the return process within a day of collecting your sample to allow enough delivery time. Refer to the shipping instructions provided in this box, or ask your prescriber, for more information. 

    Patients should be advised of the caution listed in the Cologuard Patient Guide. Patients should NOT drink the preservative liquid. 

    The risks related to using the Cologuard Collection Kit are low, with no serious adverse events reported among people in a clinical trial. Patients should be careful when opening and closing the lids to avoid the risk of hand strain. 

    Rx only.

Schedule8 Feb 2023