Researchers have developed DENEB, an investigational blood-based colorectal cancer screening assay designed to address a major limitation of current blood tests: detecting precancerous lesions, particularly advanced adenomas. In a multicenter study, DENEB detected 81% of advanced adenomas, 91% of colorectal cancers overall, and 92% of stage I–III cancers, with 85% specificity for advanced neoplasia. The test uses a multitarget approach based on circulating cell-free and exosomal microRNA signatures associated with both CRC and advanced adenomas.
The researchers emphasize that the study was not a population-based screening trial and should not be interpreted as evidence that DENEB is ready to replace colonoscopy or established screening tests. The next step is a large prospective study in an actual screening population to validate its performance. A positive blood test would still require colonoscopy, which remains the most effective tool for detecting and removing precancerous lesions.