Cologuard® vs Colonoscopy: What Patients Should Know

Southern Gastroenterology Specialists, PC

Both tests screen for colon cancer, but they are not the same. Understanding the difference helps you choose the test that is right for you. 

What is Cologuard®?

A home stool test that looks for blood and DNA changes linked to colon cancer. It does not look directly at the colon and cannot remove polyps.

What is a Colonoscopy?

A procedure where a doctor looks directly inside the colon, finds polyps (precancerous growths), and removes them before they can turn into cancer.

How accurate are these tests?

Cologuard® is very good at detecting existing colon cancer, but it misses many precancerous polyps. A negative test does not mean the colon is normal. Colonoscopy detects most cancers and polyps and removes them at the same time.

Why a negative Cologuard® can be misleading

Many colon cancers begin as polyps that Cologuard® may not detect. A negative result does not prevent cancer and does not guarantee a healthy colon.

Why is colonoscopy considered the gold standard

Colonoscopy is the only screening test that both detects and prevents colon cancer by removing polyps before they become cancerous.

When Cologuard® may be reasonable

For average-risk individuals with no symptoms, no prior polyps, and no family history of colon cancer who are unwilling or unable to undergo a colonoscopy.

Important to remember

A positive Cologuard® always requires a colonoscopy. A negative Cologuard® does not rule out polyps. If you are willing and medically able, a colonoscopy offers the most complete protection against colon cancer.



If you have questions, please discuss them with your gastroenterology provider.