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AGA responds to NEJM study on blood test for colorectal cancer screening

While a blood test can be an additional tool, it shouldn't be used in place of a colonoscopy.
Man getting blood test preparation in clinic
Man getting blood test preparation in clinic

The New England Journal of Medicine (NEJM) has published a study on a new blood-based screening test that can detect early-stage cancer.

Having data on a new blood-based screening test for colorectal cancer is exciting. If approved, it will help identify people who will need to undergo colonoscopy to confirm the diagnosis and ultimately help save lives. There is still much to learn, too.

Colonoscopies allow detection and removal of precancerous polyps as well as identifying cancer early when it is in the most treatable stages. The blood test reported in the New England Journal of Medicine study is only designed to pick up cancers and not precancerous polyps.

Blood tests are not interchangeable with colonoscopy for colorectal cancer screening but should prove to be an additional tool to help identify colorectal cancer early.

The Centers for Medicare and Medicaid Services (CMS) has determined it will cover a blood test for colorectal cancer screening every three years if the test achieves 74% sensitivity for CRC, 90% specificity, and FDA approval. However, a blood test that meets only the CMS criteria, will be inferior to current recommended tests and should not be recommended to replace current tests. Such a test could be recommended for patients who decline all other recommended tests, since any screening is better than no screening at all. 

Colorectal cancer ranks as the second most lethal cancer in the United States, and more and more individuals in their prime are developing it. For this reason, we have lowered the recommended age for colonoscopies to 45 years. By screening early, detecting, and removing precancerous polyps, we can prevent the development of colorectal cancer.

To combat this disease that still takes too many lives, we will need all tools available as well as to continue to refine our approaches, so we work smartly and efficiently to care for all.

Read comments from AGA’s leaders in The New York Times: A Blood Test Shows Promise for Early Colon Cancer Detection.

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