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ACS Updates Colorectal Screening Guideline to Include Blood Testing

The American Cancer Society (ACS) updated its colorectal cancer screening guideline, introducing several additional options recently approved by the Food and Drug Administration. The guideline confirms colonoscopy as the gold standard for colorectal cancer screening, but it adds a blood-based test and two new at-home stool tests as alternative options. Average-risk adults should begin screening at age 45 and continue through 75, according to this guideline. The blood-based test, called Shield, requires a blood draw at a doctor’s office, which should be done every three years. It detects altered DNA shed by tumors into the bloodstream. Since blood-based tests may miss early-stage cancers and precancerous polyps, the ACS recommends reserving them for people who decline or do not complete preferred screening options like stool tests and colonoscopies. A separate major guideline from the U.S. Preventive Services Task Force does not currently recommend blood-based tests for routine screening. For at-home screening, the ACS added two new options for stool tests: an updated multitarget DNA test called Cologuard Plus and a new multitarget RNA test called ColoSense. Both tests analyze stool samples for specific molecular markers and traces of blood and should be performed once every three years. People whose stool- or blood-based test finds signs of cancer need to follow up with a colonoscopy to complete the screening process. During a colonoscopy, a doctor inserts a flexible tube with a camera to examine the rectum and colon. This procedure allows the doctor to identify and remove precancerous polyps, while also checking for tissue irritation, swelling, ulcers and cancer. William Dahut, the chief scientific officer of the ACS, said in a CNN article that while blood-based tests are not the first choice, they offer an alternative for certain people. “There are a lot of people who can’t or won’t do a colonoscopy, or the idea of collecting their own stool for testing they just won’t do,” Dahut told CNN. “Having more options hopefully will allow more people to be screened to find cancers earlier on, and we’ll be able to cure more patients.”

GLP-1 Use Associated With Reduced Risk for Cancer Progression

Glucagon-like peptide-1 receptor agonists (GLP-1s), such as Ozempic (semaglutide), promote weight loss and manage diabetes; now researchers are studying other potential health benefits, including for people with cancer. A large, real-world study found an association between starting a GLP-1 after a cancer diagnosis and reduced risk for metastatic progression, according to results slated to be presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting. Researchers looked at health outcomes for 10,000 people with stage I to III solid-tumor cancers who started either GLP-1 therapy or dipeptidyl peptidase-4 inhibitors (DPP-4s)—antidiabetic medications that lower blood sugar by improving how the body uses insulin—after their diagnosis. People who received a GLP-1 had a 38% to 50% lower risk for progressing to stage IV disease across four cancer types: breast, colorectal, liver and non-small cell lung cancers. People taking GLP-1s after their cancer diagnosis had similar side effects as those taking DPP-4s. High GLP-1 receptor expression on tumors independently predicted a 33% lower overall risk for death. This association was the strongest in breast cancer, with a 45% risk reduction. “These results deserve cautious optimism,” Mark Orland, an internal medicine physician at Cleveland Clinic and the lead author of the study, told ASCO Daily News. “For patients managing both diabetes and cancer, the possibility that their antidiabetic medication may also be working in their favor is an encouraging finding. That said, these are observational data, and observational data have limits.”

FDA Approves Antibody-drug Conjugate for Rare Blood Cancer

The Food and Drug Administration (FDA) approved the antibody-drug conjugate Decnupaz (pivekimab sunirine) for adults with blastic plasmacytoid dendritic cell neoplasm (BPDCN), a rare and aggressive blood cancer. Decnupaz targets CD123, a protein overexpressed on BPDCN cells, and delivers a potent DNA-damaging drug directly into malignant cells to trigger cell death. The FDA based the approval on a phase I/II clinical that evaluated Decnupaz in 84 adults with BPDCN, including 33 people with previously untreated BPDCN and 51 with relapsed or refractory disease, MedPage Today reported. In newly diagnosed patients, 69.7% had all signs of cancer disappear. Treatment requires close monitoring for serious adverse events, including severe infusion-related reactions and liver side effects, specifically hepatic veno-occlusive disease, a condition where small blood vessels in the liver become blocked. Decnupaz marks the second FDA-approved CD123-targeted therapy for BPDCN, following Elzonris (tagraxofusp) in 2018. Approximately 500 to 1,000 people receive a BPDCN diagnosis in the U.S. annually. While it can affect people at any age, it predominately occurs in people ages 60 and older. The disease often has a poor prognosis and may spread across multiple areas of the body, including bone marrow, skin and lymph nodes, MedPage Today reported.