“I realized how powerful the conversation and clear recommendation from a provider can be.”
As a primary care physician, it would seem understandable – predictable, even – that getting screened for colon cancer would be something Randy just did as soon as he was eligible. That after years of telling his own patients in his own office about their need to screen, his own advice would ring loud and clear.
“I knew it was important but I didn’t make it a priority. I assumed all docs were the same: we’d get to it when we could,” he thought. Between caring for patients, spending time with his family, and somehow finding time to train for marathons, Randy felt like his days were filled to the brim.
At dinner, of all places, a friend and fellow healthcare provider disproved that assumption.
“Somehow, the subject of colon cancer screening came up and my friend mentioned he had a colonoscopy. When I admitted to him I hadn’t screened yet, he was angry. Really angry. I’m recommending people to get screened and at 55 years old I still haven’t done it myself? Ridiculous.”
Being able to encourage his patients by being a patient started with considering screening options, this time for himself, and Cologuard was at the top of his list of potential options: it was convenient, didn’t require him to miss a day of work and, perhaps most impressive to him as a healthcare provider, was shown to detect more colon cancer than a noninvasive FIT test. 1,2*†
“It made me wonder why I didn’t do this five years ago when I was first eligible to get screened,” he said. The recommendation at the time was 50, which has since been lowered to 45 for those at average risk.3
Talking to a healthcare provider – a colleague in Randy’s case – was easy. His provider agreed that Cologuard was a good choice for Randy since he was at average risk.3
A few weeks later, Randy was still caught between patient mode and provider mode when his Cologuard result came back positive. He booked an appointment for a colonoscopy to complete his screening,
“As a primary care physician, I know a positive screening result doesn’t necessarily mean cancer, so I thought I would be fine when it was time for the colonoscopy,” he explained. “I thought: I’m Randall. I’m a healthy physician. Everything goes right for me. I felt invincible, like this would naturally work out for me.”
His perspective changed quickly when his colonoscopy revealed stage I colon cancer. In the weeks leading up to his surgery and with his wife by his side at every appointment, it all clicked into place. Not just the when or the how of screening – as a doctor, he knew that just fine – but the why. It wasn’t something he would have learned in medical school or in the office.
His entire screening journey – from collecting his sample at home to the colonoscopy to surgery – he saw as a series of selfless acts for his wife of 13 years and his two daughters. And he saw what he might have spared them and himself had he screened when he was eligible.
While he can’t change his own screening journey, he’s determined to help his patients start theirs with more urgency.
“I realized how strong excuses can be,” he said. “But I realized how strong inertia is, too. And how powerful the conversation and clear recommendation from a provider can be.”
That, and what he calls a willingness to be vulnerable.
He recalls a conversation he had with a patient who was eligible to screen. He heard all of the excuses he was all too familiar with: I’m busy, I don’t want to, I don’t have a family history. It was March – Colorectal Cancer Awareness month. What his patient didn’t see under Randy’s white coat until he revealed it to her was a blue wristband that reads Survivor.
“It’s funny you should say that,” he said to her. “My kids didn’t have a family history either until 2019 when I was diagnosed with colon cancer.”
“Being a physician gave me a different perspective when it comes to screening. And sometimes, even intelligent, professional people who mean to do the right thing need to be urged to take action.”
* Results from a prospective, head-to-head, point-in-time, 90-site, pivotal study of 10,000 patients aged 50-84 years at average risk for CRC. In the pivotal study, screening colonoscopy was the reference method. (92% vs 74%P=.02) FIT
†OC FIT-CHEK, Polymedco, Inc.
This story reflects one individual’s experience. Not every person will have the same treatment, experience, outcome, or result. Cologuard is prescribed by your health care provider. Talk to your health care provider about available screening options and whether Cologuard may be right for you. There are potential risks associated with the Cologuard test and it may not be appropriate for all patients. For more information about the risks, talk to your health care provider or visit Cologuard.com/risk-information for more information.
1. lmperiale TF, Ransohoff DF, Itzkowitz SH, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370(14):1287-1297.
2. Cologuard Physician Brochure. Exact Sciences Corporation. Madison, WI.
3. Wolf AMD, Fontham ETH, Church TR, et al. Colorectal cancer screening for average‐risk adults: 2018 guidelines update from the American Cancer Society. CA Cancer J Clin. 2018;68(4):250-281.
Cologuard is intended to screen adults 45 years of age and older who are at average risk for colorectal cancer by detecting certain DNA markers and blood in the stool. Do not use if you have had adenomas, have inflammatory bowel disease and certain hereditary syndromes, or a personal or family history of colorectal cancer. Cologuard is not a replacement for colonoscopy in high risk patients. Cologuard performance in adults ages 45-49 is estimated based on a large clinical study of patients 50 and older. Cologuard performance in repeat testing has not been evaluated.
The Cologuard test result should be interpreted with caution. A positive test result does not confirm the presence of cancer. Patients with a positive test result should be referred for colonoscopy. A negative test result does not confirm the absence of cancer. Patients with a negative test result should discuss with their doctor when they need to be tested again. False positives and false negative results can occur. In a clinical study, 13% of people without cancer received a positive result (false positive) and 8% of people with cancer received a negative result (false negative). Rx only.