May 27, 2026
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New colorectal cancer screening guidelines from the American Cancer Society endorse blood tests for people resistant to colonoscopies and stool tests.
There is a saying about fitness that runs along the lines of "the best type of exercise is the one that you will do."
Updated colorectal cancer screening guidelines, released by the American Cancer Society, echo that sentiment by adding two new stool tests and a cautious endorsement of a blood test.
"The most effective screening test is the one that the patient completes," the experts who compiled the guidelines wrote.
Colonoscopies are still the best way to screen for colorectal cancer, which has been on the rise, especially among young people. But to increase screening rates, the updated guidelines now include recommendations for the use of two at-home stool tests for people at average risk: Colorguard Plus and ColoSense.
People at average risk for colorectal cancer are advised to get screened beginning at age 45. The duration between screening depends on the type of test. Stool tests should be completed every three years; colonoscopies are only necessary every 10 years.
The American Cancer Society also endorsed blood screening tests – which detect tumor DNA in the blood – but only for people who decline stool tests or colonoscopies. Blood tests are less effective at detecting precancerous lesions and early-stage colorectal cancer. People who get positive results for stool or blood tests should have a colonoscopy within six months, the updated guidelines say.
"While colorectal screening blood tests may not be as effective as other options, they are certainly better than not screening," Dr. Andrew Wolf, who led the panel, said in a news release. "So if a patient declines a stool test or a visual exam like a colonoscopy, a blood test would be the way to go, as long as the patient understands it is not as effective, and, if it is positive, they will still need to have a colonoscopy."
The American Cancer Society lowered the recommended age for first colorectal screenings from 50 to 45 in 2018, responding to increasing rates in young people. Colorectal cancer rates increased 3% a year for people under 50 between 2013 and 2022. It is now the leading cause of cancer death in men under 50 and the second leading cause of cancer death in women under 50.
Recommended screening can help prevent colorectal cancer through the removal of polyps and improve treatment through early detection. The five-year survival rate for early-stage colorectal cancer is 91% but dips to 13% for more advanced stages of the disease, according to the Colon Cancer Coalition.
"About a third of Americans are not up to date with colorectal cancer screening, Dr. William Dahut, chieef scientific officer for the American Cancer Society, told NBC News.
Added Wolf: "We hope these new options will help to close this gap. The most important message is that colorectal cancer is a disease you don't have to die from, and there's a screening test out there that's right for you."
