Kenneth Tomchik, MD, was searching for an alternate screening test for colon cancer for years; he found his answer with Madison, Wis.-based Exact Sciences' Cologuard.
Cologuard is a noninvasive colon cancer screening test for patients at average risk for cancer. It's prescribed by a physician and sent to a patient's home. The test is taken at home and sent back for analysis.
It's an alternative to the traditional colonoscopy and for patients that can't have a colonoscopy or fear colonoscopies it is the best colon cancer screening option.
"I've been looking for this test for years," Dr. Tomchik says. "With the standard colonoscopy people need to be sedated. Some people can't do that. A lot of people said they'd wait until an alternate test was out and now the alternate test is out. We have a good choice."
Prior to earning FDA approval in 2014, Cologuard was evaluated in a trial involving more than 10,000 people. It detected 92 percent of colorectal cancers and 42 percent of precancerous lesions.
"I said 'Alright! There it is!'" Dr. Tomchik says.
Since he started recommending it, Dr. Tomchik says his patients have been receptive "with many of them saying 'I'm going to tell my friends about it.'"
The test is not without its drawbacks, which Dr. Tomchik recognizes. Cologuard is not recommended for the few people who are at high risk. Examples of high-risk patients are individuals who either have personally had or have a close relative with colorectal polyps or colorectal cancer; or individuals with inflammatory bowel disease such as colitis or Crohn’s disease.
Exact Sciences recommended to follow any positive Cologuard test with a diagnostic colonoscopy to confirm a diagnosis.
Dr. Tomchik sees Cologuard as the first viable option for removing barriers associated with colon screening and reaching a market that would skip a traditional colonoscopy.
"Colon cancer shouldn't exist in the U.S. anymore because it's completely preventable," Dr. Tomchik says. "The problem is that 1 in 3 adults over the age of 50 do not get screened for colon cancer as recommended. Cologuard is a breakthrough and it's a chance for us to end colon cancer."
There is one barrier to accessing Cologuard: insurance coverage.
Cologuard is covered by Medicare, was recently listed as an A-rated service in the colorectal cancer screening guidelines of the U.S. Preventive Services Task Force list in June 2016, and was included as a HEDIS quality measure in October 2016. Presently, more than 70% of people ages 50-84 at average risk have an insurance plan that covers Cologuard, but some insurers still don’t cover the test.
However, on Dec. 12, 2016, Humana announced it would begin covering Cologuard as an in-network service covering the test to a total of 150 million people through a variety of insurance companies.
Dr. Tomchik believes every physician who advocates for regular colon cancer screenings should consider Cologuard.
"If you're trying to keep people from having cancer, [the 92 percent detection rate] is the most important number. You want to give it to as many people as possible," he says.