Colorectal cancer screening: Public support for blood test for telltale DNA and a new HEDIS measure

Results of a new Harris Poll survey done on behalf of Guardant Health shows that 92% of eligible Americans believe colorectal cancer blood tests should be accessible and covered by insurance at levels similar to Medicare.

Guardant Health markets Shield, an FDA-approved blood test for primary colorectal cancer screening. The Harris Poll conducted the survey from Feb. 24-26, 2026, among 1,189 U.S. adults, ages 45 and older.

The survey shows that blood-based biomarkers as screening tools enjoy public support even as major gaps persist in insurance coverage policies. Meanwhile, developers of quality metrics are in the process of developing measures that assess whether people are getting appropriate follow-up after positive
screening tests.

Colorectal cancer remains the third most commonly diagnosed cancer in the United States and the leading cause of cancer deaths in men under 50. Traditional screening methods, colonoscopy and stool-based tests, save lives but face documented barriers. Many patients do not return for necessary follow-up care after abnormal results, according to research cited by the National Committee for Quality Assurance (NCQA).

According to the National Cancer Institute (NCI), 72.6% of adults, ages 50 to 75 years, were up to date on colorectal screening in 2023, the latest year for which data are available. The Healthy People 2030 goal is 74.4%. NCI statistics show that the majority (62.8%) of the screening tests are colonoscopies and sigmoidoscopies, with fecal DNA test a distant second (11.1%).

Blood tests capable of detecting circulating tumor DNA offer a less invasive alternative that may improve screening participation. But the effectiveness of broad screening leading to early detection and treatment and, therefore, lower mortality from a cancer hinges to a large extent on what happens after a positive screening test result.

"Many individuals with a positive screening through a stool-based test do not receive the necessary follow-up care, such as a colonoscopy," said Brenna Lin, Ph.D., an applied research scientist at NCQA, in a news release issued earlier this month. "Ensuring that abnormal screening results are followed by timely diagnostic care is essential to achieving the full benefit of screening."

That observation reflects a quality gap the healthcare industry is only now beginning to measure systematically. The NCQA, in partnership with the Council of Medical Specialty Societies and the American Gastroenterological Association, is developing a new Healthcare Effectiveness Data and Information Set (HEDIS) measure specifically designed to track follow-up care after positive colorectal cancer screening results.

The proposed measure, "Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test," was open for public comment through March 13^, The development process included a comprehensive review of clinical guidelines, input from three NCQA advisory panels and field testing with three partner organizations to assess real-world feasibility.

This quality measure development matters for payers because it creates accountability for a critical but overlooked step in the screening pathway. It also validates the clinical value of blood-based screening, which depends on ensuring that positive results translate into timely diagnostic action.

For plans weighing coverage policies, the convergence of public demand, clinical evidence, and emerging quality metrics suggests a shifting landscape. The NCQA measure will provide standardized data on follow-up care performance, allowing plans to benchmark performance and identify improvement opportunities.

The Centers for Disease Control and Prevention is funding the HEDIS measure development, signaling government recognition that follow-up care represents a significant quality and equity issue in cancer prevention.