Colon cancer is one of the most preventable cancers—when it’s caught early. Two of the most talked-about screening options are colonoscopy and Cologuard. While both play a role in screening, they are not equivalent, and choosing the right test matters.
Let’s break down how each test works, who it’s for, and which option provides the most protection.
A colonoscopy is an outpatient procedure that allows a gastroenterologist to directly examine the entire colon using a thin, flexible camera.
Detects cancer and precancerous polyps
Removes polyps during the same procedure
Performed once every 10 years if normal
Considered the gold standard for screening
Cologuard is a stool-based test that looks for DNA changes and blood associated with colon cancer.
Cannot detect all precancerous polyps
Cannot remove polyps
Positive results require a colonoscopy
Must be repeated every 3 years
Cologuard is not recommended if you have:
A history of colon polyps or cancer
Family history of colon cancer
Inflammatory bowel disease
Unexplained GI symptoms (bleeding, anemia, weight loss)
In these cases, colonoscopy is the preferred and safest option.
If your goal is early detection AND prevention, colonoscopy is clearly superior. It not only finds cancer—it prevents it.
Cologuard = screening
Colonoscopy = screening + prevention
