Blood-based screenings are tests that use a simple blood draw to determine whether or not a person may have cancer. While these tests are still undergoing research, we anticipate that there will be substantial scientific progress on the horizon for blood-based screening for colorectal cancer (CRC).

However, it is important to note that blood-based screening for colorectal cancer is for average-risk patients, so that means these tests are for individuals who:

  • do not have symptoms
  • are 45 years or older
  • have no family history

What Exactly Is a Blood-based Screening?

A blood-based screening test is a less invasive screening test that use your blood sample to detect the presence of cancer. These screening tests can be included in routine checkups with your doctor.

It's important to note that with both stool tests and blood tests, if your test results come back positive, you need to schedule a follow-up colonoscopy to complete the screening process. 

Knowing that blood tests are fast approaching, Fight CRC along with our partners advocated to ensure that the follow-up colonoscopy after a positive noninvasive test (blood- or stool-based tests) is covered by private insurance and Medicare

We have entered a new era where blood-based biomarkers are going to expand CRC screening paradigms. Additional choices, including a simple blood draw, for asymptomatic average risk individuals, has the potential to increase screening participation. Access, guideline inclusion, and awareness are critical next steps as we seek to reduce gaps in care by providing additional effective blood-based CRC screening options."

–Dr. Whitney Jones, Senior Medical Advisor, GRAIL, Inc.

Two Types of Blood-based Screening Tests

There are two different types of blood-based screening tests for cancer: single-organ screening tests and multi-cancer early detection (MCED) screening testing. So, what’s the difference?

Single-Organ Blood Screening Test:

  • These look at only one type of cancer.
  • A yearly sample needs to be taken.
  • If you receive a positive result, a follow-up colonoscopy is necessary.

*Currently, only one blood-screening test (Septin 9/Epi proColon) is Food and Drug Administration (FDA) approved for patients over 50 who avoid or are unable to undergo colonoscopy, FIT, or gFOBT screening tests; however, the research is accelerating quickly and soon there may be more options for blood-based screening tests. Manufacturers are working to ensure coverage of additional screening tests as they are approved by the FDA.

Multi-cancer Early Detection Screening Tests:

  • Some can detect more than 50 types of cancers in one test.
  • These are designed to focus on tumors that are more aggressive.
  • They are used alongside single-organ tests for more accurate results.
  • If you receive a positive result, a follow-up colonoscopy is necessary.

Fight CRC is currently working with our advocacy partners to support legislation that would create a pathway to allow Medicare to cover MCED screening tests once they are approved by the FDA.

While this legislation wouldn’t mandate that Medicare cover these tests, it would allow for faster coverage for Medicare patients once the tests are approved.

Does Insurance Cover Blood-based Screening Tests?

Many insurance companies require a screening test to be included in U.S. Preventive Services Task Force (USPSTF) guidelines or American Cancer Society (ACS) guidelines.

It is important that you call your insurance provider to determine which screening tests that are and are not covered.

If you decide to utilize a blood test, make sure to ask your insurance provider: "If the test is positive, will subsequent testing or procedures be covered?"

Considering a Blood-based Screening Test? Talk to Your Provider!

If you're considering a blood-based screening test, be sure to talk to your healthcare provider.

Who May Consider Blood-Screening Tests for Colorectal Cancer?

Here is a list of questions to help guide your decision-making process: If you can answer “yes” to all of these questions, a blood-based screening test may be right for you! 

  • You are at the age to begin screening for average risk colorectal cancer (meaning you are 45 and have no increased risk of colorectal cancer This means you have no family history or known syndromes, such as Lynch syndrome, that put you at a higher risk.)
  • You do not have current colorectal cancer symptoms
  • You can’t get your own stool sample, or you have a history of not getting a colonoscopy. 
  • You know that you need to get a colonoscopy if you receive a positive screening test result. 

Who Should NOT Use Blood-Screening Tests to Detect Colorectal Cancer?*

If you answer “yes” to either of the following questions, you should not use blood-based screening tests.

  • You are at increased risk because of a personal history of colorectal cancer or at high risk because of a genetic predisposition or hereditary syndromes. 
  • You have symptoms of colorectal cancer. If you have signs or symptoms, you need to see your provider and have a colonoscopy. Don’t delay!

Symptoms include:

  1. Rectal bleeding or blood in the stool
  2. Ongoing changes in bowel habits (normal stools should be easy to pass and are usually brown in color)
  3. Narrower stools than usual
  4. Frequent gas pains, bloating, a feeling of fullness, or abdominal cramps
  5. Weight loss for no known reason
  6. Feeling very tired (weakness and fatigue)

*A colonoscopy is the only approved screening modality for high-risk individuals, those at increased risk, and those who are symptomatic.

To Learn More

For more information about colorectal cancer screening tests and options, please see our screening page.

If you have individual questions about colorectal cancer screening tests or blood-based screening tests, please be sure to talk with your healthcare provider.

To track the science and hear the latest news on screening options check out and sign up for our RATS program.

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