An updated version of Freenome’s SimpleScreen colorectal cancer (CRC) blood test demonstrated improved sensitivity for detecting advanced precancerous lesions (APLs), according to findings presented at the American College of Gastroenterology (ACG) 2026 Annual Scientific Meeting. At 90% specificity, the updated test achieved 80.4% sensitivity for CRC and increased APL detection sensitivity from 13.7% to 18.2%. Sensitivity for APLs with high-grade dysplasia rose from 30.5% to 41.9%.
The analysis included 9,131 samples from average-risk populations, drawing on the PREEMPT CRC trial and additional previously tested samples. Cancer detection sensitivity varied by stage, reaching 52.1% for stage I, 100% for stage II, 97.3% for stage III, and 100% for stage IV. The researchers reported that modeling projected nearly 10% fewer CRC cases and deaths and approximately 8% more life-years gained compared with the earlier test version. These are model-based projections, not observed reductions in cancer incidence or mortality.
Commenting on the findings, gastroenterologist Michael Dougherty noted that improved precancerous lesion detection could potentially expand the test’s role beyond cancer detection. However, blood-based screening still has limitations compared with FIT and colonoscopy, particularly for detecting advanced adenomas. The article emphasizes that blood tests may be an option for average-risk patients unwilling to undergo established screening methods, provided positive results lead to diagnostic colonoscopy.