Guardant Health acquired early cancer-detection startup MetaSight Diagnostics for $59 million upfront plus up to $90 million in contingent payments, and announced aggressive 2026 guidance for its Shield colorectal cancer screening test. Guardant forecast screening revenue of $162–$174 million and volumes of 210,000–225,000 tests for 2026. Executives cited growing physician demand, high adherence rates, and a new commercial collaboration with Quest Diagnostics as drivers of the expected ramp. Guardant said the MetaSight deal broadens its screening portfolio and underpins continued scaling of its blood-based screening business. The transaction signals consolidation in the MCED and screening market as incumbents position for reimbursement and guideline inclusion; investors and partners will watch real-world uptake and payer decisions closely.