THE ROLFE REVIEW ARTICLE: MARCH 2026 EDITION

Learning About the Cancerguard Test

Understanding the Science

Early detection remains one of the greatest challenges in pancreatic cancer, where symptoms often appear only after the disease has advanced. New blood-based tests are being studied to help detect cancers earlier, particularly those that currently have no routine screening options. One such test is Cancerguard, a multi-cancer early detection (MCED) blood test developed by Exact Sciences, the company behind Cologuard.

Cancerguard is designed to look for early warning signals linked to more than 50 cancers, including pancreatic cancer, using a simple blood draw. Even very small or early tumors can release subtle clues into the bloodstream, and the test is designed to detect those signals.

The test looks for two main types of markers. First, it analyzes small fragments of DNA that may be shed by cancer cells, focusing on chemical patterns called DNA methylation that can help distinguish cancer-related DNA from normal DNA. Second, it measures certain proteins in the blood that are associated with cancer. These protein signals are particularly important for cancers like pancreatic cancer, which often release very little DNA in early stages.

These DNA and protein signals are evaluated together using advanced computer-based analysis. By combining multiple signals rather than relying on a single marker, the test aims to better identify cancer-related patterns while limiting false positives. Importantly, Cancerguard does not diagnose cancer or locate a tumor. Instead, it is intended to identify individuals who may benefit from further evaluation.

What Happens After a Positive Result?

A positive Cancerguard result does not necessarily mean a person has cancer. It means the test detected a signal that should be evaluated more closely. Follow-up typically involves imaging—most often a high-quality CT scan, and sometimes a PET-CT scan—to determine whether cancer is present and where it may be located. Additional testing may be recommended based on imaging results and individual risk factors. The goal is to confirm or rule out cancer while avoiding unnecessary procedures whenever possible.

The science behind Cancerguard is rooted in decades of academic research. The foundational work began at Johns Hopkins University School of Medicine, where researchers developed an early multi-cancer blood test prototype known as CancerSEEK. This research demonstrated that combining tumor DNA analysis with protein biomarkers could improve the early detection of multiple cancers.

Rolfe Pancreatic Cancer Foundation has a long-standing history of supporting pancreatic cancer research at Johns Hopkins and was an early contributor to the CancerSEEK research, recognizing its potential to change the trajectory of cancers that lack effective screening tools. That work later led to the formation of Thrive Earlier Detection, which was acquired by Exact Sciences in 2021, helping move this research from the laboratory toward clinical use.

Like all emerging MCED tests, Cancerguard does not detect every cancer. In studies, it identified approximately one-third of early-stage pancreatic cancers—an important step forward in a disease for which no proactive screening currently exists. Detection rates are higher for aggressive cancers such as pancreatic cancer across all stages, and the test maintains a high level of accuracy in ruling out cancer when it is not present.

Multi-cancer early detection tests like Cancerguard are still evolving, but ongoing research suggests they may play an increasingly important role in how cancers—particularly those with few early warning signs—are detected in the future.

As part of this continued evaluation, Endeavor Health and its primary care physicians are participating in a clinical study of a multi-cancer early detection blood test. Conducted in partnership with Exact Sciences and Baylor Scott & White Health, the study will follow thousands of patients to better understand test performance, patient experience, and the broader impact of early cancer detection over time.

Multi-cancer early detection tests like Cancerguard are still evolving, but ongoing research suggests they may play an increasingly important role in how cancers—particularly those with few early warning signs—are detected in the future.