Learn How to Use Cologuard at Home

What Cologuard Is and How It Works

Cologuard is a colorectal cancer screening test that you can perform at home. It's a non-invasive test that looks for signs of colorectal cancer and advanced precancerous polyps in a stool sample. The test was approved by the FDA in 2014 and has become an option for people who want to screen for colorectal cancer without visiting a medical facility for a colonoscopy or other procedure.

The test works by detecting DNA mutations and blood in your stool that may indicate colorectal cancer or precancerous growths. Cologuard looks for specific genetic mutations that are associated with colorectal cancer cells. This makes it different from other at-home screening tests like FIT (fecal immunochemical test), which only detect blood in the stool.

According to research published in medical journals, Cologuard detects approximately 92% of colorectal cancers and about 42% of advanced adenomas (large precancerous polyps). These statistics are important to understand when considering your screening options. The test is most effective in people over age 45 to 50, though your doctor may recommend starting earlier based on your personal or family history.

The test is performed on a stool sample that you collect yourself in your home bathroom. You place the sample in a collection tube that contains a preservative to keep the DNA stable during shipping. The entire collection process typically takes just a few minutes. Once you've collected the sample, you mail it back to the laboratory in a prepaid shipping container that comes with your kit.

Practical Takeaway: Cologuard is a stool-based screening test you can do at home that detects DNA changes and blood associated with colorectal cancer. It detects about 9 out of 10 colorectal cancers, making it a meaningful screening option for many people.

Ordering Your Cologuard Kit and What Arrives

To obtain a Cologuard kit, you'll need a prescription or order from a healthcare provider. This is an important step—Cologuard is not available for direct purchase without medical authorization. You can contact your doctor, gastroenterologist, primary care physician, or visit an urgent care clinic to request a Cologuard order. Some healthcare providers may offer telemedicine visits if you prefer to consult remotely about colorectal cancer screening options.

Once your healthcare provider places the order, the kit will be shipped directly to your home address. The package typically arrives within 3-7 business days, though shipping times may vary depending on your location and current shipping volumes. When the kit arrives, you'll receive a collection tube, collection brush, instructions for use, a prepaid return shipping label, and a prepaid shipping box.

The collection tube contains a special preservative solution designed to stabilize the DNA in your stool sample. This preservative is crucial because it keeps the genetic material intact during the time between when you collect your sample and when it reaches the laboratory for testing. The preservative also kills any bacteria in the sample that might interfere with the results.

Inside the package, you'll find detailed written instructions with step-by-step guidance on how to collect your sample. Many kits include illustrations and QR codes that link to video demonstrations showing exactly how to perform the collection. Reading these instructions before you begin the collection process helps ensure you collect the sample correctly, which is important for getting accurate results.

Practical Takeaway: You need a healthcare provider's order to get Cologuard. Once ordered, the kit arrives at your home with everything you need, including a collection tube with preservative, instructions, and prepaid shipping materials.

Preparing for Your Cologuard Collection

Before you collect your Cologuard sample, there are specific preparation steps you should follow to make sure your results are as accurate as possible. Unlike colonoscopy preparation, which requires fasting and bowel cleansing, Cologuard has simpler requirements, but they're still important to follow.

For three days before collecting your sample, you should avoid taking certain medications and supplements. Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, and vitamin E supplements should be stopped three days before collection because they can cause bleeding that might affect your results. High-dose vitamin C supplements should also be avoided during this period. If you take aspirin or other medications regularly for heart health or other medical reasons, check with your doctor before stopping them—don't stop prescription medications without medical guidance.

You should also avoid certain foods for three days before collection. Red meat, including beef and lamb, can interfere with test results because it contains hemoglobin that may be detected as blood. Poultry and fish are fine to eat. Avoid processed meats like hot dogs, bacon, and deli meats. Additionally, you should limit fiber supplements during this period, though eating regular fiber from fruits and vegetables is generally okay. Some people find that their normal diet works without special changes, but following these guidelines gives you the best chance of accurate results.

Check the specific instructions that come with your kit, as recommendations may be updated. Your kit should include a detailed dietary list of foods to avoid and foods that are safe to eat. Taking a few minutes to review this list before your preparation period begins helps you plan your meals accordingly and avoid accidentally consuming something that might affect your results.

Practical Takeaway: For three days before collection, stop aspirin and NSAIDs, avoid red meat and processed meat, and skip vitamin E supplements. These steps help prevent false results. Check your kit's instructions for the specific preparation guidelines.

Step-by-Step Collection Process

Collecting your Cologuard sample is straightforward, but following each step carefully is important for test accuracy. The collection takes place entirely in your home bathroom, and the process typically takes less than five minutes once you're ready to begin.

First, prepare your bathroom by laying out all the materials from your kit: the collection brush, the collection tube with preservative, your toilet, and the instruction card. Some people find it helpful to read through the instructions once more before starting. When you're ready, use the toilet normally. Do not flush yet—you need to collect the sample from the toilet bowl before flushing.

Use the collection brush, which typically has a long handle, to collect a small amount of stool from the toilet bowl. You don't need a large amount—the brush should pick up a sample roughly the size of a grape or larger. Place the brush with the collected sample into the collection tube containing the preservative solution. The brush should be fully inserted into the tube so that the collected material mixes with the preservative liquid. Some kits have a screw-on cap that you twist to lock the brush in place; others may have a different closure mechanism.

Once you've sealed the collection tube with the brush inside, label it with your name and date of birth as instructed on the kit. Shake the tube gently for a few seconds to ensure the sample mixes with the preservative. Place the sealed tube into the prepaid shipping box that came with your kit. Include any other materials requested in your instructions. Seal the shipping box with the prepaid label and place it in your mailbox for pickup, or take it to a mail carrier or post office.

Practical Takeaway: Collect a sample from the toilet bowl using the provided brush, place it in the preservative tube, label it with your name and date of birth, and mail it using the prepaid shipping materials.

Shipping Your Sample and What Happens Next

After you've collected and sealed your sample, getting it to the laboratory is the next step. The prepaid shipping label included in your kit is addressed to the Cologuard laboratory. You can place the sealed shipping box in your home mailbox and raise the flag for pickup, or you can take it to a post office, mailbox center, or other location that accepts mail. Most people use standard U.S. mail service, which is included in the prepaid shipping cost.

The laboratory typically receives samples within 2-3 business days after mailing, depending on your location and mail service speed. Once the laboratory receives your sample, staff members check that it was collected properly and that it meets the requirements for testing. They verify that you included all necessary information and that the sample appears to be in good condition for analysis.

The actual laboratory testing