09/02/2025
A colonoscopy is not only important to detect cancer but to remove any pre-cancerous polyps.
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American Society of Gastroenterology Position on Blood-Based Colore**al Cancer Screening
Colore**al cancer (CRC) is the second leading cause of cancer-related death in the United States.
Screening for early detection of CRC and prevention (through removal of precancerous polyps) is the best and most effective way to reduce the incidence and mortality of CRC.2 There are multiple screening modalities available, including colonoscopy, f***l immunochemical testing (FIT), multi-target stool DNA tests, and blood-based tests.3
Among these, colonoscopy remains the gold standard due to its dual role in detection and prevention. Non-invasive stool-based methods provide alternative options for individuals hesitant about colonoscopy. Meanwhile, blood-based screening, which has recently been FDA approved, expands non-invasive options but bring certain limitations in terms of sensitivity and specificity, particularly with respect to advanced precancerous lesions (APL).
While the American Society for Gastrointestinal Endoscopy (ASGE) recognizes the potential for the blood-based test to improve screening participation, particularly among those who are unwilling to undergo other screening modalities, ASGE does not recommend the blood test as a first line screening tool. ASGE has determined that blood-based tests are inferior to established screening options (i.e., colonoscopy and stool-based tests), especially concerning APL detection.
