New option for colorectal cancer screening: What you need to know, and which one is right for you

Earlier this week, a blood-based screening test to detect colorectal cancer was approved by the Food and Drug Administration (FDA). While it’s not the first blood-based screening test approved by the FDA to detect colorectal cancer, the Shield blood test is the first to be approved as a primary screening option.

Colorectal cancer screening should begin at age 45 for those at average risk. It’s great that there are options—evidence suggests more options mean more people will get screened: According to the Prevent Cancer Foundation’s 2024 年早期检测调查, nearly a third (32%) of adults who reported not being up to date or weren’t sure if they were up to date on their colorectal cancer screening indicated alternative options such as a less invasive screening or test 或者 an at-home option would make them more likely to prioritize their routine colorectal cancer screenings.

But we get it—it can be confusing to navigate and find the right option for you. Here’s what you need to know to make an informed decision for yourself and your health:

What is the new FDA-approved blood-based screening test?

The Shield blood test, developed by Guardant Health, is approved for adults ages 45 and older who are at average risk of colorectal cancer. Health care providers can offer the test as a primary screening option alongside the many other screening options that currently exist for colorectal cancer.

It is important to note that the test is not yet incorporated into current U.S. Preventive Services Task Force (USPSTF) screening guidelines for colorectal cancer. Additionally, it is not recommended for people at increased risk of colorectal cancer, who may need to start regular screening at an earlier age and/or be screened more often.

A positive result from the Shield test should be followed up by a timely colonoscopy.

Is the blood-based screening test covered by my insurance?

To determine which screening tests are covered by your insurance, it’s best to contact your insurance provider. It’s also important to talk to your health care provider to discuss your personal screening plan and what’s best for you.

What other options exist for colorectal cancer screening?

In addition to blood-based, there are two other categories of colorectal cancer screening tests: visual and stool-based. The options below are included in current guidelines set by USPSTF. Talk with your health care provider about your personal and family health history to select the right one for you.

Visual tests

Colonoscopy: every 10 years

In this procedure, a tube with a light and a camera gets inserted through the rectum into the colon to look for irregularities. Not only does this procedure screen for cancer, but it can also remove pre-cancerous polyps (growths), making it preventive against cancer too.

CT colonography (virtual colonoscopy):* every five years

Less invasive than a traditional colonoscopy, the virtual colonoscopy is a procedure that uses a CT-scan and X-rays to examine the colon for abnormalities.

Flexible sigmoidoscopy:* every five years

Compared to a colonoscopy, this procedure examines only the lower part of the colon. The procedure involves a tube with a camera so the doctor can view the inside of the colon.

粪便检查

Guaiac based fecal occult blood test (gFOBT):* every year

This stool-based test is sent to a lab to detect if there is blood in the stool. After getting a kit from a health care provider, you can take the test at home and mail in your results.

Fecal immunochemical test (FIT):* every year

This stool-based test is sent to a lab to detect if there is blood in the stool. After getting a kit from a health care provider, you can take the test at home and mail in your results.

Multitarget stool DNA test (mt-sDNA):* every three years

这项基于粪便的检测可检测是否存在血液或 DNA 突变。您可以在家进行检测，然后将结果邮寄到实验室。

*如果虚拟结肠镜检查或柔性乙状结肠镜检查结果异常，FOBT、FIT 或 sDNA 检测呈阳性，应及时进行结肠镜检查。

What else can I do to reduce my risk of colorectal cancer?

In addition to routine screening, you may reduce your risk for colorectal cancer through lifestyle-related modifications:

• Exercise for at least 30 minutes, at least five days a week.
• Avoid or limit alcohol. To reduce your risk of cancer, it’s best to avoid alcohol completely. If you do choose to drink, limit your drinking to no more than one drink a day if you were assigned female at birth, and no more than two drinks a day if you were assigned male at birth.
• 请勿吸烟或以任何方式使用烟草。
• Eat less red meat and cut out processed meat.
• 保持健康的体重。
• Eat lots of fruits, vegetables and whole grains.

Learn more about colorectal cancer screening guidelines recommended by USPSTF 和 ways to reduce your risk.