UnitedHealthcare (UHC) issued a Commercial Medical Policy covering the Shield™ blood-based colorectal cancer (CRC) screening test for eligible average-risk individuals, effective August 1, 2026. UHC is the first major commercial payer to make a coverage decision about blood-based CRC screening—one that may influence other insurers. 

UHC will cover Shield blood tests for eligible average-risk adults who meet specific clinical criteria. Notably, patients will have to agree to have a follow-up colonoscopy if they have an abnormal Shield™ test result before UHC will agree to cover the Shield™ test.  

While the policy expands access to blood-based screening and increase screening rates for patients who would otherwise not get screened, ASGE believes that it is important for health care professionals to understand the efficacy of the different CRC screening tests-keeping in mind that colonoscopy is the only screening modality that both detects colorectal cancer and prevents cancer by finding and removing precancerous polyps. 

UnitedHealthcare's own evidence review notes that currently available blood-based tests are best viewed as an option for individuals who decline established screening methods.  

ASGE is seeking clarification on several aspects of the policy, including: 

• UHC’s vision on how physicians are supposed to document the requirement for patients who have an abnormal test result to undergo follow-up colonoscopy?
• Whether UHC has evaluated to what extent this requirement will create additional administrative burden for physician practices?

ASGE is engaging with United Healthcare on this policy and will continue to monitor other commercial payers as blood-based CRC screening continues to evolve. The Society remains committed to promoting evidence-based colorectal cancer screening policies that improve patient outcomes, preserve access to colonoscopy, and support completion of the full colorectal cancer screening continuum. 

Share ASGE's Know Your Risk resources with referring providers and patients to support informed, evidence-based colorectal cancer screening decisions.