You have a kit. Now what?
Do something with it. The kit is a real test, and a kit in a drawer screens no one. But before you open it, know this: you can still choose the colonoscopy instead, and most doctors will refer you the moment you ask.
The difference, in one line: Cologuard finds most cancers and about 43 of 100 advanced precancers, and it can’t remove anything. Colonoscopy looks at the whole colon and removes polyps in the same visit.
Answered by Stephen Rudolph, MD, a practicing gastroenterologist. Self-funded, with no money from any test maker. Reviewed November 2026.
If you can have a colonoscopy
Call the clinic that gave you the kit, or your gastroenterology practice, and say:
“I’d rather have the colonoscopy. Can you refer me?”
That one sentence is usually all it takes. Screening colonoscopy is preventive care, covered by most plans with no copay. After a normal, high-quality exam, most people at average risk are done for 10 years.
If colonoscopy isn’t right for you, or you’ve decided against it
Follow the instructions in the box and send it back. Then remember two things about the result:
Positive: you need a colonoscopy to finish. Arrange it promptly; your screening isn’t complete until it is done, and it is covered as part of screening.
Negative: cancer is very unlikely. Advanced precancer is not ruled out: in the FDA’s review, about 1 in 15 people with a negative result still had it. Test again in three years.
What happens after a positive resultWhy a negative result isn’t “all clear”
Have symptoms, such as bleeding or a lasting change in bowel habits, a close relative with colon cancer, or past polyps? A stool test isn’t the right tool for that. Talk with your clinician first.
Tap a question for the short answer.
No. A kit on your counter is not a commitment. Call the clinic that gave it to you and ask for a colonoscopy referral; most will be glad to arrange it.
If you have already sent the kit in, wait for the result. A positive result means a colonoscopy comes next. A negative result makes cancer very unlikely, but it does not rule out advanced precancer, and you can still talk with your clinician about a colonoscopy.
For most people, yes, and at little or no cost. Most U.S. health plans and Medicare cover a screening colonoscopy as preventive care with no copay or deductible when you use in-network care. Being offered a kit first doesn’t change that. A quick call to your insurer before the day confirms it.
Usually for good reasons that have nothing to do with which test finds more precancer: guidelines say the best test is the one that gets done, clinics are scored on whether patients are screened at all, and a short visit leaves little time to explain the difference.
Your doctor can’t know how willing you are unless you say so.
You can, but one of them is usually enough. If you are going to have the colonoscopy, have it; it already looks at everything the kit tests for, and can remove what it finds. If you have decided against colonoscopy, do the kit on schedule and keep doing it: every three years, with a colonoscopy after any positive result.
The homepage walks through it in four steps. It takes about five minutes, and it is worth it before you choose a test.
Reviewed November 2026 by Stephen Rudolph, MD. Detection figures are from the BLUE-C study (2024) and the FDA review of Cologuard Plus; sources are on the comparison page and in the evidence library. General education, not medical advice. Your clinician knows your history; this page doesn’t.