Blood-based screening for colorectal cancer (CRC), known as a “liquid biopsy,” may be used for patients who skip traditional screening tests, but cannot replace colonoscopy as the gold standard due to higher rates of false positives and false negatives. Two modeling studies and expert consensus suggest that while blood tests may be more convenient, they are not as effective or cost-effective as colonoscopy. Current tests by Guardant Health and Freenome are in development. The studies indicate that blood-based screening is not as effective or cost-effective as traditional screening methods such as FIT, stool DNA testing, and colonoscopy, and should not be recommended as a replacement. High sensitivity and specificity are needed for blood tests to be effective in CRC screening.
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