| Test | Cost (US) | What It Measures | Sensitivity for CRC | Sensitivity for Adenoma |
|---|---|---|---|---|
| Colonoscopy | $1,250–$4,800 avg ~$2,400 uninsured $0 insured (preventive) |
Direct visualization of colon mucosa. Gold standard. Allows removal during procedure. | >95% | ~75–90% Misses flat adenomas 27% |
| FIT (fecal immunochemical) | $10–$50 covered by most insurers |
Blood in stool. Detects bleeding lesions only. | 60–90% | <40% Misses non-bleeding adenomas |
| Cologuard (stool DNA) | $599 Medicare $502 / 3 years insurer coverage varies |
NDRG4 + BMP3 methylation + KRAS mutation + hemoglobin in stool. Statistical model trained on cancer data. | 92% | 42% Misses most pre-cancerous adenomas |
| Epi proColon / mSEPT9 (blood) | ~$170 FDA approved 2016 Medicare does not cover |
SEPT9 gene methylation in plasma cfDNA. Detects cancer cells shedding aberrantly methylated DNA. | 48–72% | 11% Not designed for adenoma detection |
| Shield (Guardant, blood) | ~$895 FDA approved 2024 Medicare coverage in progress |
cfDNA methylation + copy number + fragment features. ML model trained on cancer cases. | 83% | 13% Pre-cancer detection remains limited |
| 450K / EPIC array (bulk beta) | $200–$400 research / direct-to-consumer not clinically reimbursed |
Global mean methylation beta across 450K–850K CpG sites. GAPE current primary input. | Unknown Not validated for CRC screening |
Unknown Pre-clinical research only |
| GAPE-native cycling class panel (does not yet exist) |
Est. $150–$250 at scale; one blood draw no bowel prep required |
Targeted bisulfite sequencing of 20–50 cycling-class-specific CpG loci from cfDNA, with tissue-of-origin deconvolution. Physics-derived threshold — no cancer training data required. | Unknown Prospective validation needed |
Potentially high Measures pre-cancerous entropy not cancer-shed DNA |
| Tissue / Class | Existing clinical test | Cost | GAPE-native equivalent |
|---|---|---|---|
| Colon (cycling) | Cologuard, Shield, Epi proColon, FIT | $10–$895 | Cycling-class cfDNA panel (not yet built) |
| Cervix (cycling) | FAM19A4/miR124-2 methylation (European guidelines) | ~$80–$150 | Closest existing analog to GAPE cycling class |
| Breast (secretory) | BRCA promoter methylation (research), Galleri (multi-cancer) | $200–$950 | Secretory-class cfDNA panel (not yet built) |
| Prostate (secretory) | PSA (protein), GSTP1/RASSF1A methylation (research) | $30–$150 (PSA) | Secretory-class cfDNA panel (not yet built) |
| Pancreas (secretory) | CA 19-9 (protein, late), EUS (endoscopy) | $50–$2,000 | Secretory-class cfDNA panel (not yet built) |
| Immune (blood) | CBC with differential, flow cytometry | $15–$200 | Bulk blood beta gives immune class directly — most reliable class from blood draw |
| Neuron (terminal) | CSF tau/amyloid, PET imaging | $1,000–$5,000 | Neural cfDNA deconvolution (research only — 0.5% of blood cfDNA) |