{"id":27237,"date":"2026-05-27T12:02:47","date_gmt":"2026-05-27T12:02:47","guid":{"rendered":"https:\/\/readtrends.com\/en\/blood-test-colorectal-screening-acs\/"},"modified":"2026-05-27T12:02:47","modified_gmt":"2026-05-27T12:02:47","slug":"blood-test-colorectal-screening-acs","status":"publish","type":"post","link":"https:\/\/readtrends.com\/en\/blood-test-colorectal-screening-acs\/","title":{"rendered":"American Cancer Society Adds Blood Test to Colorectal Screening Options"},"content":{"rendered":"<article>\n<h2>Lead<\/h2>\n<p>For the first time the American Cancer Society (ACS) has added a blood-based test to its recommended options for colorectal cancer screening, announcing the change on Wednesday. The test, Guardant Health\u2019s Shield, received FDA clearance in 2024 and is recommended only for people who cannot or will not undergo colonoscopy or stool-based tests. ACS and clinical leaders say the move aims to reach roughly one-third of Americans who are not current with screening, while emphasizing that the blood test is not a replacement for colonoscopy. The group and outside experts stress benefits for uptake but note limits in detecting early disease and precancerous polyps.<\/p>\n<h2>Key Takeaways<\/h2>\n<ul>\n<li>The American Cancer Society updated its guidance to include Guardant Health\u2019s Shield blood test as an option for those unwilling or unable to receive colonoscopy or stool tests.<\/li>\n<li>Shield was cleared by the U.S. Food and Drug Administration in 2024 and detects tumor DNA fragments in blood; studies report about 83% sensitivity for established colorectal cancers.<\/li>\n<li>The ACS recommends Shield every three years for eligible people; the test costs about $895 out of pocket and is not automatically covered by insurers.<\/li>\n<li>Shield performs best for more advanced cancers and is substantially less sensitive for stage 1 disease and cannot detect precancerous polyps that do not shed tumor DNA.<\/li>\n<li>Colonoscopy remains the preferred screening tool because it identifies and allows removal of precancerous polyps; it is typically repeated every 10 years.<\/li>\n<li>Stool-based options such as Cologuard and ColoSense remain in the guidance and are done at home or in clinic, repeated every one to three years without bowel prep.<\/li>\n<li>Colorectal cancer incidence is rising, especially in younger adults; more than 108,000 new colon and nearly 50,000 rectal cancer diagnoses are expected in the U.S. this year.<\/li>\n<\/ul>\n<h2>Background<\/h2>\n<p>Colorectal cancer screening has traditionally hinged on colonoscopy, which allows clinicians to visualize the colon and remove polyps before they turn cancerous. Colonoscopy is widely regarded as the gold standard because it both detects cancer at early stages and prevents cancer by excising precancerous lesions. Despite its effectiveness, colonoscopy uptake is incomplete: public health data show about one-third of Americans are not current with recommended screening.<\/p>\n<p>Newer, less invasive alternatives have been developed to expand access and convenience. Stool-based molecular tests and at-home kits have been available for years and are intended to lower barriers related to preparation, time off work and procedural anxiety. The Shield blood test represents a further step toward minimally invasive screening by identifying circulating tumor DNA released into the bloodstream by established tumors.<\/p>\n<p>Policy and coverage pathways are distinct in the U.S.: an ACS recommendation can influence clinical practice but does not by itself trigger automatic insurance coverage. Coverage decisions often follow guidance from the U.S. Preventive Services Task Force and insurers\u2019 own reviews, neither of which has broadly mandated payment for the new blood test at the time of the ACS announcement.<\/p>\n<h2>Main Event<\/h2>\n<p>The ACS released updated colorectal cancer screening guidance that adds the Shield blood test as an alternative for people who decline or cannot complete more sensitive tests like colonoscopy or stool testing. The panel framed the change as an access strategy\u2014offering an option that may capture people who otherwise avoid screening. ACS leaders emphasized that the test should not replace higher-yield modalities.<\/p>\n<p>Shield, produced by Guardant Health, was cleared by the FDA in 2024 to detect DNA fragments shed by colorectal tumors. Clinical studies presented with the clearance reported roughly 83% sensitivity for detecting colorectal cancers overall, with substantially lower sensitivity for early-stage disease and no ability to detect most precancerous polyps, which typically do not release measurable tumor DNA.<\/p>\n<p>ACS chief scientific officer Dr. William Dahut said expanding options could \u201cdramatically increase\u201d screening uptake among the roughly one-third of Americans not up to date with testing. He noted the group&#8217;s preference for colonoscopy and stool tests but framed Shield as a pragmatic alternative for people unlikely to participate otherwise.<\/p>\n<p>Practicing clinicians offered mixed but measured responses at the release. Some welcomed another tool to reach unscreened populations; others warned that the convenience of a blood test could unintentionally supplant more effective prevention strategies in some patients. The ACS guidance reiterates that any positive result from a noninvasive test requires confirmatory colonoscopy to locate lesions and guide treatment.<\/p>\n<h2>Analysis &#038; Implications<\/h2>\n<p>The ACS decision is primarily pragmatic: offering Shield could reduce the absolute number of people who remain unscreened and therefore may detect cancers that would otherwise present at symptomatic, later stages. Given rising colorectal cancer incidence under age 50 and the substantial proportion of adults lapsed in screening, even a less-sensitive test can yield population-level benefits if it reaches people who would not be screened at all.<\/p>\n<p>However, the test\u2019s limited ability to find early-stage cancers and its inability to detect most precancerous polyps mean it is an imperfect prevention tool. Colonoscopy prevents cancer by removing polyps; a blood test that cannot identify those lesions cannot substitute for that preventive function. Overreliance on blood testing in patients who would otherwise accept colonoscopy may therefore reduce the overall preventive impact of screening programs.<\/p>\n<p>Economic and policy consequences are uncertain. Shield\u2019s listed out-of-pocket cost is about $895, and ACS guidance does not automatically translate into insurer coverage. Many U.S. payers base coverage on U.S. Preventive Services Task Force decisions; the USPSTF had not issued a directive that would require coverage for the blood test at the time of ACS\u2019s update. Absent broad coverage, uptake may be limited to those who can afford the test or have specific access arrangements.<\/p>\n<p>Clinically, the guidance places emphasis on shared decision-making: providers should discuss the relative benefits, limitations and likely downstream steps (including colonoscopy after a positive noninvasive result) with patients. For public-health planners, the central question is whether adding the blood option will raise net screening rates and, ultimately, reduce advanced cancers and deaths\u2014or whether it will shift people away from more preventive modalities.<\/p>\n<h2>Comparison &#038; Data<\/h2>\n<figure>\n<table>\n<thead>\n<tr>\n<th>Test<\/th>\n<th>Mode<\/th>\n<th>Primary target<\/th>\n<th>Sensitivity (reported)<\/th>\n<th>Detects precancerous polyps?<\/th>\n<th>Typical interval<\/th>\n<th>Out-of-pocket cost<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td>Colonoscopy<\/td>\n<td>Endoscopic exam<\/td>\n<td>Polyps and cancers<\/td>\n<td>High for polyps and cancer<\/td>\n<td>Yes (removable)<\/td>\n<td>Every 10 years<\/td>\n<td>Varies by insurance<\/td>\n<\/tr>\n<tr>\n<td>Shield (Guardant)<\/td>\n<td>Blood test<\/td>\n<td>Cancer-derived DNA fragments<\/td>\n<td>~83% for cancers (studies)<\/td>\n<td>No<\/td>\n<td>Every 3 years<\/td>\n<td>About $895 (out of pocket)<\/td>\n<\/tr>\n<tr>\n<td>Stool-based tests (Cologuard\/ColoSense)<\/td>\n<td>Stool sample<\/td>\n<td>Molecular markers of cancer<\/td>\n<td>Variable (test-dependent)<\/td>\n<td>Limited<\/td>\n<td>Every 1\u20133 years<\/td>\n<td>Varies by insurance<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/figure>\n<p>The table summarizes key practical differences: colonoscopy is both diagnostic and preventive, stool tests are noninvasive and repeated more often, and Shield offers a minimally invasive blood option with known limits in polyp detection. These trade-offs are central to counseling patients and planning screening programs.<\/p>\n<h2>Reactions &#038; Quotes<\/h2>\n<p>Clinical leaders and researchers offered cautious endorsement focused on increasing screening while warning about misplaced confidence in convenience.<\/p>\n<blockquote>\n<p>&#8220;About a third of Americans are not up to date with colorectal cancer screening,&#8221;<\/p>\n<p><cite>Dr. William Dahut, Chief Scientific Officer, American Cancer Society<\/cite><\/p><\/blockquote>\n<p>Dr. Dahut framed the addition as a way to capture people who would otherwise go unscreened, stressing that the option is for those who will not undergo colonoscopy or stool tests.<\/p>\n<blockquote>\n<p>&#8220;This is better than nothing, for sure,&#8221;<\/p>\n<p><cite>Dr. Scott Kopetz, Gastrointestinal Medical Oncologist, MD Anderson Cancer Center<\/cite><\/p><\/blockquote>\n<p>Dr. Kopetz noted clinicians\u2019 concern that ease may drive some patients away from higher-value screening and prevention, potentially reducing the net preventive benefit.<\/p>\n<blockquote>\n<p>&#8220;Getting screened is more important than ever,&#8221;<\/p>\n<p><cite>Dr. Kimmie Ng, Director, Young-Onset Colorectal Cancer Center, Dana-Farber<\/cite><\/p><\/blockquote>\n<p>Dr. Ng emphasized the public-health rationale: a menu of acceptable options can improve uptake among populations resistant to traditional methods.<\/p>\n<aside>\n<details>\n<summary>Explainer: How the tests differ<\/summary>\n<p>Shield searches for circulating tumor DNA\u2014small fragments of DNA shed by existing tumors\u2014making it useful for detecting established cancers but not for many early or precancerous lesions. Stool-based molecular tests look for cancer-associated DNA and blood in feces and can detect a proportion of cancers without bowel prep. Colonoscopy visually inspects the colon and allows immediate removal of polyps; it requires bowel preparation, sedation and a procedural visit but is the only test that also prevents cancer by excising precursors.<\/p>\n<\/details>\n<\/aside>\n<h2>Unconfirmed<\/h2>\n<ul>\n<li>Whether widescale use of Shield will reduce colorectal cancer mortality at the population level remains unproven; long-term outcome data are not yet available.<\/li>\n<li>How rapidly insurers will adopt coverage for Shield is unresolved; ACS guidance does not guarantee payer reimbursement and the U.S. Preventive Services Task Force has not issued a coverage-triggering recommendation for the blood test.<\/li>\n<li>The net effect of adding a blood option on colonoscopy uptake and overall prevention rates across diverse populations is uncertain and may vary by region and patient preference.<\/li>\n<\/ul>\n<h2>Bottom Line<\/h2>\n<p>The ACS decision to include Guardant Health\u2019s Shield blood test in its colorectal screening options is a pragmatic attempt to expand screening access and reach people who currently decline available tests. Shield\u2019s FDA clearance and reported ~83% sensitivity for cancers make it a meaningful option for those who would otherwise not be screened, but its limitations\u2014poor detection of early-stage cancers and an inability to find most precancerous polyps\u2014mean it cannot replace colonoscopy as a prevention tool.<\/p>\n<p>Clinicians should use shared decision-making to match patients with the most appropriate test, clearly communicating that a positive noninvasive result requires colonoscopy for diagnosis and treatment planning. Policymakers and insurers will need to decide how coverage and screening programs adapt; the public-health impact will depend on whether adding the blood option increases net screening and reduces advanced cancers without displacing higher-value preventive care.<\/p>\n<h2>Sources<\/h2>\n<ul>\n<li><a href=\"https:\/\/www.nbcnews.com\/health\/health-news\/blood-test-added-colorectal-cancer-screening-options-cancer-group-rcna346902\" target=\"_blank\" rel=\"noopener\">NBC News<\/a> \u2014 media report summarizing ACS guidance and expert reactions<\/li>\n<li><a href=\"https:\/\/www.cancer.org\" target=\"_blank\" rel=\"noopener\">American Cancer Society<\/a> \u2014 official organization (guidance and recommendations)<\/li>\n<\/ul>\n<\/article>\n","protected":false},"excerpt":{"rendered":"<p>Lead For the first time the American Cancer Society (ACS) has added a blood-based test to its recommended options for colorectal cancer screening, announcing the change on Wednesday. The test, Guardant Health\u2019s Shield, received FDA clearance in 2024 and is recommended only for people who cannot or will not undergo colonoscopy or stool-based tests. ACS &#8230; <a title=\"American Cancer Society Adds Blood Test to Colorectal Screening Options\" class=\"read-more\" href=\"https:\/\/readtrends.com\/en\/blood-test-colorectal-screening-acs\/\" aria-label=\"Read more about American Cancer Society Adds Blood Test to Colorectal Screening Options\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":27236,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"rank_math_title":"ACS Adds Blood Test to Colorectal Screening Options | Insight Health","rank_math_description":"The American Cancer Society now lists Guardant Health\u2019s Shield blood test as an option for people who decline colonoscopy or stool tests; it detects cancers ~83% of the time but isn\u2019t proven to save lives yet.","rank_math_focus_keyword":"colorectal cancer, Shield, American Cancer Society, blood test, screening","footnotes":""},"categories":[2],"tags":[],"class_list":["post-27237","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-top-stories"],"_links":{"self":[{"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/posts\/27237","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/comments?post=27237"}],"version-history":[{"count":0,"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/posts\/27237\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/media\/27236"}],"wp:attachment":[{"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/media?parent=27237"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/categories?post=27237"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/readtrends.com\/en\/wp-json\/wp\/v2\/tags?post=27237"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}