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Closing the Gaps in Colon Cancer Screening, With Gabriella McCarty, NP
McCarty explains progress made with new screening options but emphasizes ongoing barriers hindering screening goals and how they need to be addressed.
Colon cancer remains one of the most preventable yet least prevented cancers. Despite advances in screening, uptake across the US remains suboptimal, with no state yet meeting the American Cancer Society’s national goal of screening 80% of eligible adults and an estimated 60 million US adults remaining unscreened.
At the 2025 Gastroenterology & Hepatology Advanced Practice Providers (GHAPP) conference, colon cancer screening and surveillance were at the forefront in a workshop led by Gabriella McCarty, NP, a gastroenterology/hepatology nurse practitioner at North Shore Gastroenterology.
In an interview with HCPLive, McCarty described progress made in screening due to updated guidelines and increased discourse about screening online and on social media. However, she also called attention to several barriers that continue to prevent people from getting screened, including lack of awareness about the new screening age, cost, and inability to get in with a gastroenterologist.
Regarding new screening options available to patients who may not be willing or able to get a colonoscopy, McCarty was careful to note differences in their sensitivity and specificity for detecting colon cancer.
In 2024, the US Food and Drug Administration approved Exact Sciences’ Cologuard Plus test, the company’s next-generation multitarget stool DNA test, and Geneoscopy’s ColoSense, a noninvasive multi-target stool RNA colorectal cancer screening test, for adults ≥ 45 years of age at average risk of developing colorectal cancer. Also in 2024, the FDA approved Guardant Health’s Shield blood test for primary colorectal cancer screening in average risk adults ≥ 45 years of age.
“There has to be shared decision making with the patient. Even if they agree to colonoscopy, if they're never going to schedule it, then you haven't done your job,” she said. “The bottom line is, the best test is the test that actually gets done.”
McCarty also emphasizes the need for better education among primary care providers to ensure they are aware their patients should now be getting screened at 45 years of age, noting it took the American College of Gastroenterology a few years to update their guidelines after the American Cancer Society changed the screening age in 2018.
“Early detection is the best way to prevent death from colon cancer,” McCarty said. “Ideally, [screening] is something that is not so expensive, easy to do, and gets people to follow through and do it.”
References
American Cancer Society. 80% in Every Community. Accessed September 9, 2025. https://nccrt.org/our-impact/80-in-every-community/
Brooks A. FDA Approves Exact Sciences’ Cologuard Plus Test for Colorectal Cancer Screening. HCPLive. October 4, 2024. Accessed September 9, 2025. https://www.hcplive.com/view/fda-approves-exact-sciences-cologuard-plus-test-for-colorectal-cancer-screening
Campbell P. FDA Approves ColoSense, a Noninvasive mt-sRNA Test, for Adults 45 or Older. HCPLive. May 7, 2024. Accessed September 9, 2025. https://www.hcplive.com/view/fda-approves-colosense-a-noninvasive-mt-srna-test-for-adults-45-or-older
Brooks A. FDA Approves First Blood Test for Primary Colorectal Cancer Screening. HCPLive. July 29, 2024. Accessed September 9, 2025. https://www.hcplive.com/view/fda-approves-first-blood-test-primary-colorectal-cancer-screening
