# OPEN LETTER: To You Who Have Put Off Colorectal Cancer Screening for Years


- Author: Maxime Marquette
- Publisher: MadMax (https://mad-max.co)
- Section: Open letter
- Published: 2026-07-27
- Canonical URL: https://mad-max.co/en/article/to-you-who-have-put-off-colorectal-cancer-screening-for-years

## You Who Keep Postponing This Appointment

The **FDA** has approved **SimpleScreen™ CRC**, a blood-based colorectal cancer screening test, for adults **45 and older** at average risk, according to **Freenome** and **Abbott**. I am writing directly to you, who have pushed your screening back year after year, because this piece carries news that concerns you specifically.

**Abbott** will commercialize this test exclusively in the **United States** starting this fall **2026**, still according to **Freenome** and **Abbott**. This is not a distant promise: it is a concrete date, a few months away.

### What This Approval Actually Changes for You

If you are **45** or older and at average risk, you will soon have a screening option that requires no preparatory fasting, no sedation, no day off work: a simple blood draw, in an ordinary doctor's office.

### Why I Am Writing to You, Not to an Abstract Reader

According to **Freenome**, as many as **60 million Americans** remain behind on recommended screening. That figure is not a distant statistic: it likely includes someone who looks like you, maybe even you. This letter is written for that exact person.

## Reuters Confirms What Freenome Announces

**Reuters** reports that the **FDA**'s authorization gives **Freenome** its first commercial product and paves the way for **Abbott** to launch the test in the United States this fall. Two independent sources, one announcement confirmed without contradiction on this central point.

The test, **SimpleScreen CRC**, detects signals associated with colorectal cancer from **circulating free DNA** (**cfDNA**) in the blood, according to **Freenome**. A technology that relies on what your own blood already carries, with no invasive sampling required.

### What Circulating Free DNA Actually Means

Tumor cells, when present, release fragments of **DNA** into the bloodstream. It is this fragmented genetic material, **cfDNA**, that the test analyzes to detect signals associated with the presence of colorectal cancer, without needing direct access to the colon.

### Why This Approach Changes the Nature of Screening Itself

A test built on a blood draw shifts screening's barrier to entry: it is no longer about overcoming the dread of a colonoscopy, but simply accepting a routine medical procedure, already familiar to anyone who has ever had a standard blood test.

## The PREEMPT CRC Study, the Evidence Behind the Promise

In the **PREEMPT CRC** study, conducted on more than **48,000 asymptomatic adults** across more than **200 sites**, **SimpleScreen CRC** detected colorectal cancer with **81.1%** sensitivity and advanced precancerous lesions with **13.7%** sensitivity, according to **Freenome**. I am giving you these numbers exactly as reported, without rounding or dressing them up.

**Reuters** notes that the test also showed **30.7%** sensitivity for high-risk precancerous lesions, and that it will compete with **Guardant Health**'s **Shield**. That last detail matters: you will not have a single option on the market, but a choice among several competing blood tests.

### What These Percentages Mean for You, Without the Jargon

A sensitivity of **81.1%** for colorectal cancer means that, out of a hundred people who actually have colorectal cancer, roughly eighty-one will be correctly identified by the test. That is not an absolute guarantee, but a measurable improvement over no screening at all.

### Why Sensitivity to Precancerous Lesions Remains More Limited

The **13.7%** sensitivity for advanced precancerous lesions is notably lower than for cancer that has already developed. This piece does not hide that limit: it means this test detects an existing cancer better than a lesion that might, one day, become one.

## A Colonoscopy Remains Essential After a Positive Result, I Tell You Clearly

**CancerNetwork** reports that a positive result must be followed by a colonoscopy, and that the test should not replace a diagnostic or surveillance colonoscopy in high-risk populations. I am not writing to convince you to avoid the colonoscopy: I am writing to tell you an additional option now exists.

If this test detects a signal, the colonoscopy remains the unavoidable next step to confirm or rule out that signal. This test is an entry point, not a diagnostic conclusion in itself.

### Why This Distinction Protects Your Health Rather Than Compromising It

Understanding that this test is a screening tool, not a final diagnosis, protects you from two opposite mistakes: dismissing a positive result because you assume the test is unreliable, or refusing a follow-up colonoscopy because you assume the test was already sufficient.

### Who This Test Is Not For, Based on the Available Sources

**CancerNetwork** specifies that this test should not replace a diagnostic or surveillance colonoscopy in high-risk populations. If your personal or family medical history places you in that category, this letter does not speak to you in the same way: discuss it directly with your doctor.

## Medicare and Medical Guidelines May Soon Shift

**CancerNetwork** states that the approval also means **SimpleScreen CRC** meets **Medicare** coverage criteria, and should be incorporated into **American Cancer Society** guidelines. For you already wondering whether this test will be accessible and covered, here is a partial but concrete answer.

This potential Medicare coverage does not automatically mean immediate universal coverage across every private insurance plan: this piece names that limit rather than promising guaranteed access for everyone.

### What Incorporation Into American Cancer Society Guidelines Would Mean

If the **American Cancer Society** does incorporate this test into its official guidelines, that would change how primary-care doctors routinely discuss it with patients, rather than mentioning it only to those who ask about it themselves.

## To You Who Fear the Colonoscopy More Than the Cancer Itself

I know that fear of the preparation, of the procedure itself, or simply of the embarrassment associated with a colonoscopy has held some of you back for years. That is not a weakness to blame yourself for: it is a real psychological barrier, documented by the very figure **Freenome** cites on the **60 million Americans** behind on screening.

This new test does not claim to eliminate that fear for good. It offers a less intimidating first step, one that could bring you toward the colonoscopy sooner than you might have otherwise kept postponing indefinitely.

### Why Starting With a Blood Draw Can Unlock Years of Inaction

For many people, the obstacle is not a lack of information about why screening matters, but the anxious anticipation of a specific procedure. Replacing that first step with a routine medical gesture can be enough to unlock a decision postponed for years.

## The Limits of This Evidence, I Name Them Too Without Hiding Them

Sources reviewed for this letter do not agree on the comparative scope of the market: **Reuters** discusses competition with **Guardant Health**'s **Shield** test, while **Freenome** mainly emphasizes expanded access to screening. I do not choose between these two framings: I report both to you.

Efficacy accountings remain partial: **Freenome** gives **81.1%** and **13.7%**, **Reuters** adds **30.7%** for high-risk lesions, but no source reviewed details performance by full demographic subgroup.

### Why This Honesty About Limits Matters More Than a Reassuring Promise

A letter that promised you total reliability would betray the real material available. I would rather give you exact numbers, with their limits, than a simplified version that would falsely reassure you about what this test can actually guarantee.

### What Exact Clinical Use Does Not Yet Specify

The exact clinical use remains limited in the available sources: we know a positive result must lead to a colonoscopy, but the recommended retesting frequency, and its precise place within existing care pathways, are not confirmed by every source reviewed.

## Boursorama and Zonebourse Confirm This Announcement in French

According to **Boursorama**, "the **FDA** approves Freenome's blood test for colorectal cancer screening," an article confirming, in French, the same announcement reported by English-language sources. **Zonebourse** uses nearly identical phrasing the same day.

This dual French-language confirmation, published the same **July 27, 2026** as English-language sources, shows this announcement did not stay confined to the American market: it circulated, almost simultaneously, in French-language financial press.

### Why This French-Language Convergence Strengthens Trust in This Letter

Drawing on a first-hand French-language source, rather than a simple translation of an English-language wire story, confirms this announcement circulates independently in the French financial press, and not only through American agency pickups.

## The Regulatory Document That Makes All This Official

The **FDA** itself published the Premarket Approval (**PMA**) under reference **P250029**, dated **July 27, 2026**. This is not a commercial announcement without regulatory grounding: it is a precise administrative act, publicly searchable, that makes this approval verifiable beyond corporate press releases.

That same regulator had already approved a competing test, **Guardant Health**'s **Shield**, under reference **P230009** in **2024**. You will therefore soon have two blood-based options approved by the same authority, not just one.

### Why Having an Already-Approved Competitor Matters for You

The fact that **Guardant Health**'s **Shield** had already secured its approval in **2024** means the very principle of a blood-based colorectal screening test is not a complete novelty: it is a market already forming, where **SimpleScreen CRC** arrives as a serious second competitor rather than an isolated pioneer.

## The Scientific Literature Was Already Laying the Groundwork

A scientific article available on **PMC**, dated December **2025**, already documented the technical foundations of a blood-based colorectal cancer screening test, even before the **FDA**'s specific approval of **SimpleScreen CRC**. This scientific head start shows this approval did not appear out of nowhere: it caps years of published research.

This piece does not claim that this article specifically documents **SimpleScreen CRC** itself, but it confirms that research on blood-based colorectal screening tests was already active and published before the commercial announcement of July **2026**.

### Why This Scientific Head Start Should Strengthen Your Confidence

A test approved after years of peer-reviewed, published research is not an improvised innovation. This documented scientific lineage, even without an explicit direct link to the precise commercial product, adds to the credibility of the underlying technological approach.

## To You Who Have a Parent or Loved One Affected by This Cancer

If a family member has already received a colorectal cancer diagnosis, you already know why screening matters. But I must tell you clearly: sources reviewed for this letter do not detail whether **SimpleScreen CRC** was specifically validated for people at elevated family risk, as opposed to the average risk documented by the **PREEMPT CRC** study.

**CancerNetwork** specifies that this test should not replace a surveillance colonoscopy in high-risk populations, which generally includes people with a direct family history. This letter cannot decide for you: your situation requires a specific conversation with your doctor, not a general reading like this one.

### Why I Cannot Generalize This Announcement to Your Specific Situation

The **PREEMPT CRC** study was conducted on asymptomatic adults at average risk, according to **Freenome**. Nothing in the sources reviewed allows anyone to claim the same sensitivity figures would apply identically to a population at elevated family risk, which generally follows a different surveillance protocol.

## The Verdict These Facts Impose, to You Reading This Letter

You who have postponed your screening for years, here is what I can tell you with certainty from the sources gathered: a new blood test approved by the **FDA** will soon exist, with a documented sensitivity of **81.1%** for colorectal cancer, but more limited sensitivity for precancerous lesions, and it never replaces a follow-up colonoscopy after a positive result.

What I cannot promise you is immediate universal insurance coverage, absolute reliability, or a complete elimination of any eventual need for a colonoscopy. This letter gives you the exact facts, not a promise prettier than the reality it describes.

### What You Should Take Away in One Sentence

If you are **45** or older, at average risk, and have been postponing your screening for too long, an **FDA**-approved blood test will arrive this fall in the United States, without replacing a colonoscopy after a positive result, but lowering the barrier to entry you may have dreaded for years.

## To You Wondering Why Now, and Not Sooner

You may be wondering why this test did not exist sooner, when colorectal screening has been recommended for decades. The answer, documented by the scientific article available on **PMC** and by the very existence of a competitor already approved in **2024**, lies in the technical maturation needed to reliably analyze **circulating free DNA** in blood.

This is not a question of delayed institutional will: it is a question of technological capability that has only recently advanced enough to make this kind of test reliable at the scale of a **48,000**-person study.

### Why This Technical Maturation Explains the Timing, Not an Institutional Delay

The gap between identifying the need for expanded screening and this specific technology's arrival does not reflect inaction by regulators or companies: it reflects the time needed to scientifically validate a detection method reliable enough to earn approval from a regulator like the **FDA**.

## It Is Now Up to You to Take the Next Step

I end this letter the way I began it: speaking directly to you. No source reviewed here replaces a conversation with your own doctor about your personal risk, your family history, and the right timing for your next screening.

What this letter can do is inform you that one more option will soon exist, documented by verifiable sources, with its strengths and limits named clearly rather than hidden.

### Why I Choose to End on a Question Rather Than a Promise

If **60 million Americans** remain behind on their screening according to **Freenome**, the real question this letter leaves you with is not "is this test perfect?" but "what has been holding you back, specifically, and does this option change anything for you?"

## To You Still Hesitant to Bring Up Screening With Your Doctor

If the only thing this letter changes for you is asking a precise question at your next medical appointment — "is there now a blood test for colorectal screening, and is it right for me?" — then it will have done its job. The sources gathered here never replace that direct conversation.

I cannot know, from this letter, your exact personal risk, your complete family history, or the details of your current insurance coverage. Only your doctor, with your full record, can answer those questions precisely.

### Why Asking the Question Costs Less Than Continuing to Avoid It

Asking your doctor this question commits you to nothing: it simply opens a conversation that could, depending on your specific situation, point you toward this new option as soon as it reaches the market this fall, or toward a colonoscopy if your risk profile calls for it right away.

### What This Letter Hopes to Have Accomplished, and Nothing More

This letter does not hope to convince you of a specific choice: it hopes only that you now have facts clear, sourced, and honest enough to make that decision with your doctor, rather than continuing to postpone it for lack of information.

### What I Would Ask You to Do With This Letter Once You Have Finished Reading

Do not file this letter away as background reading. Fold it into the next conversation you already have planned with your doctor, or use it as the reason to schedule one if none is planned. The sources cited here remain public and verifiable, should your doctor want to review the same regulatory filing and study data referenced throughout this letter.

**By Maxime Marquette, columnist**

## Columnist's transparency note

### Editorial stance

I am not a journalist but a **columnist and analyst**. My expertise lies in observing and analysing the geopolitical, economic and strategic dynamics that shape our world. My work is to take political strategies apart, to understand global economic movements, to put the decisions of international actors in context and to offer analytical perspectives on the changes that are redefining our societies.

I do not claim the cold objectivity of traditional journalism, which stops at reporting facts. **I claim analytical clarity**, rigorous interpretation and a deep understanding of the complex issues that concern us all. My role is to give meaning to the facts, to place them in their historical and strategic context, and to offer a critical reading of events.

### Method and sources

This text keeps the basic distinction between **verified facts and interpretive analysis**. The rule never changes: a factual claim is published only when a verifiable source supports it, and the sources this article actually used are listed under **Sources**, never here.

**Primary source families** used by the publication, when the story has them: official statements from governments and international institutions, public statements by political leaders, reports from intergovernmental organisations, dispatches from recognised international news agencies.

**Secondary source families**: specialised publications, internationally recognised news media, analyses from established research institutions, reports from industry organisations.

When an article cites statistical, economic or geopolitical data, it comes from the institutions that produce it (intergovernmental organisations, central banks, national statistics offices), and the exact institution is named under **Sources**.

### Nature of the analysis

The analyses, interpretations and perspectives in the analytical sections of this article are a **critical, contextual synthesis** based on the information available, the trends observed and the expert comments cited in the sources consulted.

My role is to interpret these facts, to set them in the context of today's geopolitical and economic dynamics, and to give them a coherent meaning within the larger story of the changes shaping our time. These analyses reflect expertise built through continuous observation of international affairs and an understanding of the strategic mechanisms that drive global actors.

This article describes a documented state of affairs on its publication date, not a prediction: later developments may shift its outlook. No update is promised in advance; when an article is corrected or completed, the change is dated in the text.

## Sources

### Primary sources

- [Premarket Approval (PMA) P250029 — FDA](https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P250029)

- [Shield – P230009 — FDA](https://www.fda.gov/medical-devices/recently-approved-devices/shield-p230009)

- [A Blood-Based Test for Colorectal Cancer Screening — PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC12795244/)

### Secondary sources

- [FDA Approves Freenome's SimpleScreen CRC Blood-Based Screening Test — Freenome](https://www.freenome.com/newsroom/fda-approves-freenomes-simplescreen-crc/)

- [FDA approves Freenome's blood test for colorectal cancer screening — Reuters](https://www.reuters.com/legal/litigation/fda-approves-freenomes-blood-test-colorectal-cancer-screening-2026-07-27/)

- [FDA Approves Blood-Based Test for Colorectal Cancer Screening — CancerNetwork](https://www.cancernetwork.com/view/fda-approves-blood-based-test-for-colorectal-cancer-screening)

- [La FDA approuve le test sanguin de Freenome — Boursorama](https://www.boursorama.com/bourse/actualites/la-fda-approuve-le-test-sanguin-de-freenome-destine-au-depistage-du-cancer-colorectal-e709332babd53518743f760d6849fe22)

- [La FDA approuve le test sanguin de Freenome — Zonebourse](https://ch.zonebourse.com/actualite-bourse/la-fda-approuve-le-test-sanguin-de-freenome-pour-le-depistage-du-cancer-colorectal-ce7f51dcdf8afe20)

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Source: Maxime Marquette, MadMax. When citing, name the author and link https://mad-max.co/en/article/to-you-who-have-put-off-colorectal-cancer-screening-for-years