Colonoscopy Yield in Cologuard-Positive Patients Across Age Groups

Colorectal

Douglas K. Rex, MD, MASGE reviewing Anderson JC, et al. Dig Dis Sci. 2026 Nov.

In a study of 2201 patients undergoing colonoscopy for a positive Cologuard, the odds of any adenoma increased with age, but the prevalence of advanced lesions was similar across age groups. For example, the prevalence of any advanced adenoma was 22.3% in 45- to 49-year-olds, 22.7% in 50- to 59-year-olds, 19.8% in 60- to 69-year-olds, and 17.1% in those aged 70 years or older. The prevalence of any advanced polyp, including advanced adenomas and important serrated polyps, was 46.6%, 46%, 42.4%, and 36.3%, respectively, in the age groups.

Comment:

These data indicate that the positive predictive value of Cologuard is substantial across all age groups. In contrast, previous findings show that the positive predictive value of fecal immunochemical tests and symptoms such as rectal bleeding typically increases with age.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

Douglas K. Rex, MD, MASGE

Bio and Disclosures

Citation(s):

Anderson JC, Hisey WM, Robinson CM, Limburg PJ, Greene M, Butterly LF. Outcomes and characteristics across age groups of patients with positive MT-sDNA stool tests: data from the New Hampshire Colonoscopy Registry. Dig Dis Sci. 2026;71:5428-5433. (https://doi.org/10.1007/s10620-026-10082-w)