ALL ABOUT ACCURACY

So you want to use a Cologuard Plus® test

But you have questions. Maybe about its accuracy, or how it compares to another use-at-home stool test — or what the Cologuard Plus test is to begin with. Let’s get you answers so you can get screened for colon cancer, especially if you’re 45 or older and at average risk.
Exact Sciences Corporation | July 2026
A man holds a Cologuard Plus box in his living room.

Key takeaways

  • The Cologuard Plus test is a noninvasive stool DNA screening test for adults 45 and older who are at average risk for colon cancer.
  • It’s simple to collect your sample at home with no prep, fasting, or downtime required.
  • A positive Cologuard Plus test result does not mean you have colon cancer, but it does mean you should follow up with a colonoscopy.
  • Compared to another common stool test — the fecal immunochemical test (FIT) — the Cologuard Plus test detected more precancerous growths in a clinical study.1
  • Regular screening is important, because colon cancer can develop without noticeable symptoms.2

Simple to use, noninvasive, no downtime, and no prep needed. Made for people 45 years and older who are at average risk for colon cancer, it is the only FDA-approved stool DNA test. With over 20 million tests completed,3 it’s easy to see why Cologuard is an option many people consider.

That’s all well and good, you may be thinking. But what is it, really? And how simple is simple? And as far as results go, how accurate is it compared to other stool tests?

With so much information online, it can get confusing for many people. Well, that ends here. From top to bottom, this guide will explain how to use a Cologuard Plus test, how it stacks up to another way to screen for colon cancer, and how you can request one today.


Start with Cologuard Plus


How do I use a Cologuard Plus test?

To really answer the question that many people online have about using the Cologuard Plus test, here it is: Yes, you do have to poop in a box. Well, not literally. Let me explain.

Inside every Cologuard Plus box is a uniquely designed stool collection kit created to ensure your sample is returned to the lab safely (and sanitarily!) for testing. This kit is what you set up on your toilet to collect a sample.

When your box arrives, it will contain a step-by-step, simple-to-follow instruction guide together with the following:

  • Sample container
  • Probe + tube
  • Bracket
  • Sample labels
  • Bottle of liquid preservative
  • Return shipping label
Illustration of what components are included in a Cologuard Plus box.
What's inside your Cologuard Plus box.

Once you’re done, it’s important to box and ship your kit right away, ideally on the same day or the next at the latest. To do this, you can schedule a pickup with UPS®, or drop it off at the nearest location to you. Pro tip: To avoid shipping delays, use your kit after the weekend or the holidays.

Once the lab receives your kit, it’ll take 8-10 days to get your test result.

What about my results? Does a positive result mean I have colon cancer?

Okay, let’s talk test results. With the Cologuard Plus test, you will either get a negative or a positive result.

Negative
You don’t have to screen for the next 3 years, as recommended by the American Cancer Society.4

Positive
This is not a colon cancer diagnosis. It simply means that abnormalities were detected, and you need to undergo further testing via a colonoscopy. The best thing to do is to share your test result and discuss next steps with your doctor.

Wait, how accurate is the Cologuard Plus test?

In a study that included nearly 19,000 average-risk patients aged 45-86, the Cologuard Plus test detected 95% of Stage I to IV colon cancers1 — a level of sensitivity similar to a colonoscopy, based on separate studies.5*† And in a subset of 20 adults aged 45-59, the Cologuard Plus test detected 100% of all colon cancers.1

One. Hundred. Percent. That’s all the percent.

How does it compare to other stool tests?

Compared to another common stool test — the fecal immunochemical test (FIT) — the Cologuard Plus test was shown to detect more precancer — both advanced precancerous lesions and sessile serrated lesions.1

I also read something about false positives and negatives. What are those?

When it comes to false positives and negatives, they can occur with the Cologuard Plus test. Think of a false positive as a false alarm, while a false negative means something was missed during testing.

But false negatives are rare. The Cologuard Plus test has a false negative rate of just 5%.1

It’s important to note that no test is 100% accurate at any given time — such is the nature of scientific testing. This is why it’s crucial to discuss your results with your doctor, who can order additional tests if needed, based on your symptoms and medical history.

So… Can the Cologuard Plus test (or another stool test) substitute for a colonoscopy?

No, sorry. It’s important to keep in mind that stool tests can detect colon cancer, but they cannot prevent or cure it. A positive stool test result requires a follow-up colonoscopy, where doctors can examine the colon and remove polyps right then and there.4

Stool tests are recommended for people 45+ with an average risk of colon cancer. High-risk individuals include those who have a family or personal history of colorectal cancer.

Included as well are people who have certain medical conditions such as IBS, Crohn’s disease, or chronic ulcerative colitis. If you have these conditions, you are not advised to use stool tests and should get a colonoscopy instead.

Speaking of stools… Is it true that pencil-thin stools are a definite sign of colon cancer?

Nice segue, by the way. And the answer is no. Pencil-thin stools do not automatically mean colon cancer. However, they are a potential symptom, especially if they are accompanied by other symptoms, such as blood in the stool, unexplained weight loss, stomach pain, or a drastic change in bowel habits.6 If having pencil-thin stools is unusual for you, or if they persist, it’s highly advised that you see a doctor so they can figure out what’s going on, and what needs to be done. It’s a good idea to get screened, even if you don’t have noticeable symptoms.

Hmm…are there other noninvasive stool tests I can use at home?

Yes, as mentioned above, there’s the FIT test. And there’s also the Guaiac-based fecal occult blood test (gFOBT). Both are over-the-counter tests that detect occult (hidden) blood in the stool. You can use them at home and send your sample back to a lab for testing.

The FIT and the Cologuard Plus test are similar in that neither requires prep, medication, or a special diet. Meanwhile, a gFOBT needs you to avoid certain medications such as NSAIDS and vitamin C, as well as red meat and raw fruits and veggies days before testing.

While the Cologuard Plus test is prescription-based, it is also the only FDA-approved stool DNA test. And it’s covered by most insurance plans, including Medicare.

I’m ready to get screened for colon cancer. How do I get the Cologuard Plus test?

First of all, congrats and well done. Colon cancer is often considered the most preventable, yet least prevented cancer.7 So the decision to get screened means you’re taking care and taking charge of your health. And yes, if you’re 45 or older and at average risk, now is the best time to begin your journey.

Let’s begin by confirming your insurance covers the Cologuard Plus test. Once that’s done, let’s get your request in. You can also ask your doctor to write a prescription and order one on your behalf.

If you have more questions — or if you’re interested in topics that weren’t covered in this guide — don’t worry. Our Customer Service team is happy to help. Every day, from 6 AM to 10 PM CT, you can give us a call at +1 844-870-8870.

Safe.
Noninvasive.
FDA-approved.