Blood-Based Test May Help Increase Colorectal Cancer Screening Rates

Aasma Shaukat, MD, MPH, spoke with CancerNetwork^® at the 2025 ASCO Gastrointestinal Cancers Symposium about how a blood-based test may expand the accessibility of colorectal cancer (CRC) screening among average-risk populations in the US. She spoke in the context of findings she presented from the PREEMPT CRC study (NCT04369053) evaluating the specificity and sensitivity of an investigational blood-based test for CRC detection.¹

According to Shaukat, the modality she assessed in the PREEMPT CRC study may add to the list of screening options for average-risk populations, thereby increasing screening rates in the US. To further bolster access to CRC screening, she described a need for local, regional, and national policy to reduce barriers to care for patients who lack insurance or have other social determinants of health.

Findings from the PREEMPT CRC study showed a sensitivity rate of 79.2% for CRC detection via blood-based testing and a specificity rate of 91.5% for advanced colorectal neoplasia (ACN). The negative predictive value and positive predictive value for ACN was 90.8% and 15.5%, respectively.

Shaukat is a Robert M. and Mary H. Glickman Professor of Medicine in the Department of Medicine, a professor in the Department of Population Health, co-director of Translational Research Education and Careers, and director of Outcomes Research in the Division of Gastroenterology and Hepatology.

Transcript:

Currently, our screening methods include either colonoscopy or stool-based tests. There is one current blood-based test that is also approved.² This test adds to the options for blood-based testing for average-risk populations in the US. We think with additional modalities, we could perhaps boost screening rates in the US population.

Screening is extremely important and should be universally applicable and provided to individuals who are screen-eligible, which [include] men and women [who are] 45 and older in the US. However, we know there’s a lot of barriers, the largest one being access barriers. Individuals without insurance, dedicated primary care service, or other social determinants of health are unable to access medical care, including screenings. We think that there needs to be some local, regional, and national policy to help everybody access at least screening tests for colorectal cancer.

References

1. Shaukat A, Kutnik K, Meng Z, et al. Performance of a blood-based test for colorectal cancer screening adjusted to the US census age and sex distribution. J Clin Oncol. 2025;43(suppl 4):18. doi:10.1200/JCO.2025.43.4_suppl.18
2. Guardant Health’s Shield™ blood test approved by FDA as a primary screening option, clearing path for medicare reimbursement and a new era of colorectal cancer screening. News release. Guardant Health, Inc. July 29, 2024. Accessed January 30, 2025. https://tinyurl.com/34fhzfpt