COLOGUARD TEST EXPLANATION

Understanding your Cologuard® test results

The words ‘positive’ or ‘negative’ may seem simple enough, but what do they really mean? Knowing how to interpret your Cologuard test results is key to making informed, confident decisions about your next steps.
Exact Sciences | March 2026
A man looking at his test results while on the phone with his doctor.

You took the Cologuard test in the privacy of your home. You sent it back to the lab. After 8 to 10 days, your results are back. And now, as you’re looking at the report, confusion sets in. Does a positive result mean you have colon cancer? Can you relax if it’s negative?

In this post, we’re going to explain what a Cologuard test result means, what it can and can’t tell you, and what you need to do next to turn a moment of panic into a clear plan moving forward.


Start with Cologuard

What Cologuard is and isn’t

Cologuard is a use-at-home screening test for colon cancer. When you send your stool sample back to the lab, it’s tested for tiny traces of blood and DNA changes that can be linked to cancer or precancerous growths called polyps.

While Cologuard is a screening test, it is not a diagnostic test. What does this mean? Think of it as an early warning system, like a smoke detector. You install one in your home to alert you to possible danger, but it can’t tell you what’s burning, where it is, or how big or small the flames are.

When you hear a smoke alarm go off, you don’t ignore it, right? It’s the same with Cologuard. As a screening test, it’s meant to catch potential problems that could lead to colon cancer. You can use your Cologuard test result to start a conversation with your doctor and, if needed, create a treatment plan.

Interpreting your Cologuard results

If it turns out negative

This is good news. It means your Cologuard test did not detect blood or abnormal DNA in your stool sample. Based on this result, the next time you have to screen again for colon cancer is in 3 years, as recommended by the American Cancer Society.1

A sample of a negative Cologuard test report.
Sample negative report. See the full sample report here.

If it turns out positive

Seeing this result can feel like the ground shifting under you, and it’s completely understandable. It’s frightening, and it would be so easy to give in to the fear.

Although it may be hard, take a deep breath and repeat this to yourself: A positive Cologuard test is not a cancer diagnosis.

Rather, it’s a definite sign that you need further testing. Because it’s designed to be sensitive, there could be several reasons your Cologuard test turned out positive:

  • Noncancerous polyps (very common)
  • Minor inflammation in your colon or rectum
  • Benign conditions such as hemorrhoids
  • Other sources of bleeding
  • Colon cancer and precancerous polyps

The next step? Get clarity by getting a colonoscopy. This is essential and cannot be skipped.

A colonoscopy will allow a doctor to look directly into your colon. If polyps are detected, they can be removed during the same procedure. Under the Affordable Care Act (ACA), most private insurance plans and Medicare are required to cover a follow-up colonoscopy without out-of-pocket costs for patients aged 45 to 75.

Remember that the goal is prevention through early detection. A positive Cologuard test result means you did just that. Now that something has been flagged, it’s an opportunity to be more proactive about your health.

A sample of a positive Cologuard test report.
Sample positive report. See the full report here.

The reality of false positives and negatives

In a clinical study of average-risk people ages 50-84, Cologuard detected 92% of all colon cancers2 and 94% of all stage 1 and 2 cancers.2-4 For a noninvasive screening test, these detection rates are considered high.

That being said, no screening test is 100% accurate. When people hear 'false positive' or 'false negative,' it can sound alarming. But these terms are part of how all screening tests work – including Cologuard. False positives and negatives can occur with Cologuard because it’s designed to be sensitive – meaning it can flag something that turns out to be harmless rather than miss a potential cancer growth.

The key is to have regular timely screenings, especially for people 45 and older at average risk for colon cancer. Screening works best when it’s part of an ongoing routine, not just a one-time event.

Your doctor is your ally

Seeing a doctor after a positive Cologuard test result is the important next step toward a definitive answer. Remember, what you have right now is information, not a diagnosis. Your primary care physician or health provider will have your medical history and can review your test results with you.

From there, they may refer you to a gastroenterologist, a doctor who specializes in digestive health. They will schedule a colonoscopy to determine what triggered your positive result.

If you don’t know how or where to start the conversation, here are a couple of questions to ask:

  • Could other health conditions or certain medications have affected the result? (Things like hemorrhoids are worth mentioning.)
  • Will my insurance cover a colonoscopy? (Your doctor can help you with in-network referrals to gastroenterologists.)

By reaching out to your doctor, you aren’t just scheduling a procedure — you’re gaining an expert ally who can help you feel confident knowing your health is in the best possible hands.

Safe.
Noninvasive.
FDA-approved.

The bottom line

If you’ve made it this far, here’s what matters most: Getting screened means you’ve shown up for your health. That’s something to be proud of.

Your Cologuard test result, whether positive or negative, is not a verdict. It’s about staying one step ahead. A negative result can offer reassurance and serve as a reminder to check in again after 3 years. A positive result, on the other hand, can be seen as an opportunity to get answers and, if needed, early treatment for colon cancer – when it’s most survivable. 

Above all, know it’s okay to feel all the feelings when you see your Cologuard test results. Lean on your loved ones for support, and trust that your doctors have your health and best interests at heart.