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Deven Stopa
March 24, 2022

As a main point of contact, primary care physicians often provide insight into recommended procedures for patients. At times, they are not as informed as the GI population on related issues. Consequently, they can recommend procedures that do not provide the highest quality of care.

The colonoscopy’s depth of reporting and ability to locate colorectal and precancerous polyps has given it the nickname of “The Gold Standard.” However, at times primary care doctors recommend alternative tests as they believe it may provide the same level of screening. There are several points as a GI physician you can communicate to primary care physicians to ensure they are recommending the preferred colorectal cancer screening procedure.

Alternative tests can miss cancer and precancerous polyps

Since a colonoscopy allows physicians to peer inside the body, they can accurately identify precancerous polyps of all sizes, along with any other irregularities in the colon. On the other hand, other tests can miss up to 8-percent of colon cancer and up to 50-percent of precancerous polyps, according to

Detection vs Prevention

One of the largest differences between a colonoscopy and alternate procedures is prevention vs detection. Colonoscopies can catch polyps prior to becoming cancerous, making them a preventative treatment option. Other options can only detect cancer if it already exists. This early detection of precancerous polyps can make the difference in treatment options for patients. This once again shows why the colonoscopy is the gold standard colorectal cancer prevention method.

Cost to the patient for screenings

As mentioned above, the preventative nature of the colonoscopy makes it much easier for the patient medically and financially. With the recent lowering of the recommended age for colonoscopies from age 50 to age 45, patients can now more easily access preventative care . It is designated as a preventative procedure. Therefore, colonoscopies are covered by most insurance providers.

Other forms of detection are not preventative procedures. This means that there could be a substantial cost to the patient to complete the process. Also, if an alternative test comes back positive, it can then mean more costs in regard to receiving treatment and additional procedures in the future.


When speaking to primary care physicians, know that you both have the same goal. This is to ensure that each patient is as healthy as possible. While patients and primary care doctors may see the comfort, time requirement and privacy of alternative test as the ultimate reasons to avoid a colonoscopy, make sure they understand the following:

  • These tests can only be used to identify existing cancer. As opposed to the preventative measure’s colonoscopies provide.
  • Alternative testing is NOT covered by insurance. Colonoscopies are deemed a preventative procedure and covered by nearly all insurance providers.
  • Colonoscopies can identify very small precancerous polyps that can be easily missed by other tests. This can allow for early removal and treatment of these polyps, which can help avoid cancer in the future.
  • If abnormalities are identified by an alternative test or procedure, patients must be prepared to likely pay out of pocket for the additional testing and procedures.

Want to learn more on this topic? Read our previous feature: “7 Ways to Promote the Importance of Screenings to Primary Care Physicians”