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Nov 29, 2022 1 min, 36 secs

No test is objectively better than the others. The United States Preventive Services Task Force recommends colonoscopy and stool tests equally for folks ages 45 to 75 and selectively up until 85 for someone who is otherwise healthy.

"The best colorectal cancer screening test is the one you actually choose to take," said Dr.

Although the Affordable Care Act requires colonoscopies, like other screening tests, to be offered at no cost to the patient, people are sometimes surprised with a bill for anesthesia after a colonoscopy, Kramer said?

"I don't want to discourage people who have a history of polyps from getting exams and finding polyps," said Robertson, who runs a large trial comparing colonoscopy to FIT for the Veterans Administration.

Cologuard advertises heavily on TV and has raised awareness about the need for colorectal cancer screening. This test, which requires people to collect a poop sample and mail it in, looks for certain high-risk genetic mutations as well as blood in the stool.

A positive Cologuard test could represent genetic mutations in the stool and that might prompt some doctors to do more follow up testing even after a clean colonoscopy. But the need or value of that follow-up is entirely unclear, Robertson said.

As a one-time test, Cologuard will detect more cancers than FIT, Robertson said, but over time, if done annually in the case of FIT and every three years for Cologuard, "it's a close call.

Roughly 5% to 7% of FIT tests will lead to the need for a colonoscopy, compared with 13% to 15% of Cologuard tests, he said.

With Cologuard and FIT, the cost of a follow-up colonoscopy, if needed, might not be completely covered by insurance, because it's no longer a screening test, but a diagnostic

Major health care organizations, including the Veterans Administration and Kaiser Permanente, offer FIT tests, Robertson said, with Kaiser effectively encouraging people to come back every year

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