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Background: Colorectal cancer CRC is a highly curable and preventable carcinoma if detected early, and the to most idely-accepted CRC screening tests are the fecal occult blood test FOBT and colonoscopy. FOBT is, hoever, affected by such factors as diet and drugs, resulting in lo specificity. Colonoscopy thus remains the gold standard for CRC diagnosis; hoever, colonoscopy is invasive, requires boel preparation and may cause pain, bleeding and even boel perforation. Thus it is estimated that only about 50 percent of FOBT positive patients are illing to accept colonoscopy. Methods: We used a minimally invasive blood RNA test, ColonSentry, to quantitatively evaluate a patients current risk of having CRC. This test, hich accesses the expression of a seven-gene signature for CRC, stratifies an individuals risk for having CRC ithin a range from one-tenth the risk to 10 times the risk of the average risk population i.e., the population asymptomatic for CRC, ith no personal history of benign colorectal polyps, colorectal adenomas, CRC or inflammatory boel disease, and no first degree relative ith CRC . Beteen April 2012 and December 2015, 1080 asymptomatic people underent ColonSentry blood testing at our facilities in China and Malaysia. Some participants scoring to times the average risk or higher 2x accepted colonoscopy and histological results ere obtained. Results: Of the 1080 ColonSentry participants, 559 scored above the CRC risk of the average risk population. Eighty-seven patients ith relatively high risk 2x accepted follo-up colonoscopy and of these, 11 submitted histological results. Of those 11 patients, one as histologically identified as having CRC, 2 had tubular adenoma pre-malignant , 4 had benign hyperplastic polyps, and 1 patient had a severe boel inflammation. Only 3 patients had a normal colonoscopy and 1 of them has a family history of CRC. Conclusions: This study suggests that ColonSentry, a minimally-invasive risk-stratification blood RNA test, could help the majority of lo-risk patients avoid over-examination for CRC and could aid decision-making in CRC detection. The test ould also serve to promote colonoscopy compliance and uptake in patients at high risk for CRC.,J Clin Oncol 34, 2016 suppl; abstr e15090 ,Publication Only Gastrointestinal Colorectal Cancer