UnitedHealthcare’s coverage decision for Guardant Health’s Shield colorectal cancer screening test triggered a sharp market reaction, with the test moving into first-line use for average-risk patients under defined criteria. The coverage includes adults ages 45 to 75 meeting eligibility requirements and stipulates follow-up colonoscopy after abnormal Shield results. The insurer’s policy covers roughly 30 million commercial covered lives, according to analyst estimates. The decision broadens Guardant’s pathway for adoption of liquid biopsy as a screening option and challenges existing payer positioning that restricted liquid biopsy to second-line scenarios for patients declining colonoscopy or stool testing. For Guardant, the coverage is expected to drive average selling price and volume momentum starting in August, positioning the company for expanded contracting with other payers.