Fourth, cancer screening remains a widely contested topic, prompting vigorous debates. A compromise that has emerged is, as in all cases in which the full risks and benefits are not certain, for physicians to engage patients in shared decision making that requires a commitment to full disclosure of the limits of the current evidence.8 The uncertainty regarding the true clinical utility of this newly approved test makes shared decision making difficult. Physicians must inform patients of the unknown effects of the test on mortality, the lower rate of detection of precancerous polyps, and the presence of better alternatives. Patients should be told that positive test results commit them to further investigations, likely including endoscopy. The prospect of such a lengthy discussion becoming routine seems unlikely. Moreover, SEPT9 blood testing raises concerns that like prostate-specific antigen testing, it may be ordered without specific patient consent, as part of routine blood work.