Newswise – SEATTLE – March 14, 2024 – A blood test used to screen for colorectal cancer in people at average risk and without symptoms correctly detected colorectal cancer in 83% of people with confirmed disease, according to a study published in March 14 in the New England Journal of Medicine.

The accuracy rate for colon cancer is similar to home stool tests used for early detection of colon cancer.

“The results of the study are a promising step toward developing more convenient tools for early detection of colorectal cancer while making it easier to treat,” said the corresponding author William M. Grady, MD, a gastroenterologist at Fred Hutchinson Cancer Center. “The test, which has similar accuracy in detecting colorectal cancer as stool tests for early detection of cancer, could provide an alternative for patients who would otherwise reject current screening options.”

The findings come from the ECLIPSE study, a multi-site clinical trial involving nearly 8,000 people ages 45 to 84, led and funded by Guardant Health. The ECLIPSE study compared the Guardant’s Shield blood test with colonoscopy, the current gold standard for colorectal cancer screening.

The Shield test detects colorectal cancer signals in the blood using DNA secreted by tumors called circulating tumor DNA (ctDNA). ctDNA is also used in “liquid biopsy” tests to monitor cancer recurrence in people who have been treated for cancer and for other early detection tests for new cancers.

Of the 7,861 people included in the NEJM report, 83.1% of participants with colonoscopy-confirmed colorectal cancer had a positive blood test for ctDNA and 16.9% had a negative test – in which a colonoscopy showed colorectal cancer that contained ctDNA But don’t test. The test was most sensitive for colorectal cancer, including early-stage cancer, and less sensitive for advanced precancerous lesions that can turn into cancer over time.

Grady said the blood test’s sensitivity for colon cancer is comparable to stool tests and lower than that of colonoscopy, which he still considers to be the most accurate screening test for colon cancer.

“Colon cancer is common and highly preventable through screening, but only about 50 to 60 percent of people eligible for screening take these tests,” said Grady, medical director of Fred Hutch’s Gastrointestinal Cancer Prevention Program. “Getting people to get screened for cancer works best when we offer them screening options and then let them decide what works best for them.”

According to the American Cancer Society, Colorectal cancer is the second leading cause of cancer death among adults in the United States and is expected to cause 53,010 deaths in 2024. While the death rate from colorectal cancer has declined among older adults, the rate among people under age 55 has increased by about 1% per year since the mid-2000s. Current guidelines People with an average risk of colon cancer should start regular screening at age 45.

“We continue to see younger people getting colorectal cancer, and it is now the third most common cancer in people under 50,” Grady said. “A blood-based test that people can take during routine doctor visits could be a chance to help more people get screened.”

Grady is also the Rodger C. Haggitt Professor in the Department of Gastroenterology at the University of Washington School of Medicine.

Fred Hutch and UW Medicine were not involved in the multisite ECLIPSE study. Grady is a paid member of Guardant’s Scientific Advisory Board. He advised on the design and process of the clinical study and data analysis.


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The Fred Hutchinson Cancer Center combines personalized care and advanced research to provide the latest treatments for cancer while accelerating discoveries that prevent, treat and cure cancer and infectious diseases worldwide.

Seattle-based Fred Hutch is an independent, nonprofit organization and the only National Cancer Institute-designated cancer center in Washington. We have earned a global reputation for our track record of discoveries in cancer, infectious diseases and basic research, including important advances in bone marrow transplantation, immunotherapy, HIV/AIDS prevention and COVID-19 vaccines. Fred Hutch operates eight clinical care locations offering medical oncology, infusion, radiation, proton therapy and related services. Fred Hutch also serves as UW Medicine’s cancer program.

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