Ask Nurse Jessica: New Age Guidelines for Preventative Colonoscopies/Is Cologuard Covered by UHC?

Tuesday, November 2, 2021

A Message from Jessica Johnson, UnitedHealthcare Nurse Liaison 

Welcome to my monthly column, Ask Nurse Jessica. Since joining Valencia College as your full-time UnitedHealthcare (UHC) nurse liaison, I’ve received numerous questions about how I can help you and your family make better healthcare decisions, provide support and clarification on UHC benefits; demonstrate how to navigate UHC tools and resources; refer you to appropriate wellness programs and services; provide support for chronic illnesses. 

This column is designed to answer those questions. If you would like to ask a question, simply email me with “Ask Nurse Jessica” in the subject line. Submissions will be anonymous in The Juice and The Grove and will be addressed monthly as they are received. 

This month, I’m actually covering two questions that I recently received, but they are both about colorectal cancer screenings, so I’ll answer them together.

What are the new age guidelines for preventative colonoscopies?

As of Friday, October 1, 2021, UnitedHealthcare has updated its Preventive Services Coverage Determination Guideline (CDG) with the updated colorectal cancer screening age recommendation from the United States Preventive Services Task Force (USPSTF) to expand the recommended ages for colorectal cancer screening to 45 to 75 years (previously, it was 50 to 75 years), and it applies to adults 45 years and older who do not have signs or symptoms of colorectal cancer and who are at average risk for colorectal cancer.

Is the at-home kit, Cologuard, covered by Valencia College’s UnitedHealthcare (UHC) plan as a screening tool for colon cancer? 

Yes, Cologuard is included in our health insurance plan as a colon cancer screening tool. Cologuard is an easy-to-use, noninvasive colon cancer screening test based on the latest advances in stool DNA science. It is for adults 45 years or older who are at average risk for colon cancer, and it is available by prescription only. You can obtain an order through your primary care provider. Cologuard finds both cancer and precancer.

Here are a few other things to know about the test:

  • The Cologuard Collection Kit is easy to use, and it’s shipped directly to your home.
  • You collect a single stool sample using this kit from the privacy of your home and then send it to Exact Sciences Labs via prepaid UPS shipping or pick-up.
  • No special preparation, diet or medication changes are required.
  • No time off is required.
  • The results are then provided to your doctor, who will contact you to discuss next steps.

So how does Cologuard work? Every day the lining of your colon naturally sheds cells. If you have cancer or precancer in your colon, abnormal cells shed into the colon — along with normal cells — where they are picked up by stool as it passes through. Cologuard uses advanced stool DNA technology to find elevated levels of altered DNA and/or hemoglobin in these abnormal cells, which could be associated with cancer or precancer.

Cologuard is not for everyone. It is for individuals 45 years or older, and at average risk, but it is an option we want you to know is available. Talk to your doctor about what kind of colon cancer screening test is right for you. You can learn more about Cologuard at www.cologuardtest.com.

What are some of the benefits and limits of colorectal cancer screening tests?

Here’s a little bit about each type of colon cancer screening. Be sure to talk with your doctor about which one may be right for you.

  • Stool test: There are three types of stool tests. The guaiac-based fecal occult blood test and fecal immunochemical test both check for blood in your stool (blood could be an indicator that there’s a polyp or cancer). Both kinds of tests are done once a year. The stool DNA test checks for actual cancer cells in the stool and is done every one or three years.
  • Flexible sigmoidoscopy: Your doctor inserts a little lighted tube into your rectum and lower part of the colon to check for polyps or cancer. This is done every five years (or every 10, along with that stool DNA test mentioned above).
  • Colonoscopy: This is like the flexible sigmoidoscopy, but it checks the rectum and the whole colon. During a colonoscopy, the doctor may remove anything suspicious. This screening is done every 10 years for people at average risk. It can also be a follow-up test if something concerning is found in one of the screenings listed above.
  • Virtual colonoscopy: This uses X-rays and computers to create images of your colon for the doctor to analyze. This one is done every five years.

The test you choose may depend on your health, risk factors and personal comfort level with getting screened. The important thing is to talk to your doctor who can help you pick one — and have it done regularly.

What are the benefits and limits of stool DNA test Cologuard and colonoscopy screening tests?

For other questions, contact me at jessica_r_johnson@uhc.com or 407- 866-8134.If you have any questions about your health insurance benefits or colon cancer screening options, please call the Customer Service number on your member ID card.

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