EviCore to Cover Guardant Health Shield Colorectal Cancer Blood Test

In a September 14, 2026 announcement, Guardant Health (GH ) said its Shield blood test for colorectal cancer screening will be covered in EviCore by Evernorth clinical guidelines effective January 1, 2027, per American Cancer Society guidelines. The Palo Alto, California-based precision oncology company said the policy increases total covered lives for Shield among adults ages 45 and older to approximately 94 million, which it described as representing the overwhelming majority of eligible patients in the United States.

EviCore by Evernorth is a Cigna-owned company that Guardant described as the second largest specialty benefits manager in the country, spanning more than 23 states. EviCore provides medical benefit management to Blue Cross Blue Shield and other commercial payers across the United States. According to the announcement, the new Shield policy impacts payers across 23 states, including Arkansas, Alabama, Connecticut, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maryland/D.C., Maine, Missouri, Minnesota, North Carolina, Nevada, New York, Oklahoma, Pennsylvania, Rhode Island, Tennessee, Wisconsin, Wyoming and West Virginia. The company said the updated policy offers individuals above the age of 45 who are at average risk of colorectal cancer access to the blood-based test.

Guardant said the EviCore update extends rapid growth in commercial adoption over its last fiscal quarter, following what it called meaningful coverage expansion from Carelon, which it described as the largest specialty benefits manager in the United States, and UnitedHealth Group, which it described as the largest insurer in the country.

“With the latest coverage from EviCore, an overwhelming majority of eligible Americans now have access to the most clinically-validated blood-based colorectal cancer screening option,” said AmirAli Talasaz, Guardant Health co-CEO. Talasaz characterized the expanded coverage as another critical milestone in the company’s commercial expansion and rapid adoption by insurers, part of what he described as a broader mission to make screening more accessible.

Guideline Position

In a June 2, 2025 announcement, Guardant said the National Comprehensive Cancer Network had included Shield in its updated colorectal cancer screening guidelines, with a recommendation for testing every three years. The company said that inclusion, which pointed to its ECLIPSE study comparing Shield with screening colonoscopy, was the first national guideline recommendation for the test.

In a May 27, 2026 announcement, the company said updated American Cancer Society Colorectal Cancer Screening Guidelines published that day included Shield as a choice for patients who decline or have not completed stool-based or visual examination screening tests. Guardant said Shield is the first and only FDA-approved blood test included in both ACS and NCCN guidelines, and described it as the first FDA-approved blood test for primary colorectal cancer screening in average-risk adults age 45 and older. The ACS last updated its colorectal cancer screening guidelines in 2018, when it lowered the recommended screening age for average-risk adults from 50 to 45 in response to rising colorectal cancer rates among younger adults.

Clinical Evidence and Test Design

The pivotal ECLIPSE study evaluated Shield against screening colonoscopy and demonstrated a sensitivity of 83 percent in detecting colorectal cancer, according to the company, with results published in the New England Journal of Medicine. In its May 2026 announcement, Guardant said ECLIPSE demonstrated sensitivity of 100 percent in detecting stage II and above cancers.

Guardant said more than 200,000 Shield tests have been performed in real-world settings, with the test demonstrating screening adherence above 90 percent among patients due for colorectal cancer screening across practice and health system settings. The company also said Shield demonstrates the highest performance in colorectal cancer detection across all stages compared with published FIT performance.

Shield is a methylation partitioning cell-free DNA (mp-cfDNA) non-invasive, blood-based screening test that detects alterations associated with colorectal cancer in the blood. The test detects colorectal cancer signals in the bloodstream from DNA shed by tumors, called circulating tumor DNA. It is intended as a screening test for individuals at average risk for the disease who are age 45 or older and is not intended for individuals at high risk for colorectal cancer. The test can be completed during any healthcare visit, and the company said it can be considered in a manner similar to guideline-recommended non-invasive screening options. A positive Shield result raises concern for the presence of colorectal cancer or advanced adenoma, and the patient should be referred for colonoscopy evaluation.

Guardant has framed the run of payer decisions against a persistent screening gap. In its May 2026 guideline announcement, the company said more than 50 million eligible adults remain unscreened despite established methods such as colonoscopy and stool-based testing having existed for decades, and that three out of four colorectal cancer deaths occur among people not up to date with screening. The company’s releases describe colorectal cancer as the second leading cancer killer in the United States, citing American Cancer Society statistics, note rising colorectal cancer rates among adults under 65, and identify the disease as the leading cause of cancer death among adults under 50, citing Scientific American.