The American Cancer Society has updated its colorectal cancer screening guidelines to include new blood-based and at-home stool tests, while still recommending that average-risk adults begin screening at age 45. The move aims to improve screening participation and reduce deaths, as colorectal cancer rates continue to rise among adults under 50. Colonoscopy remains the gold standard, and any positive result from a stool or blood test must be followed by a colonoscopy within six months.

Colorectal cancer is the third most common cancer worldwide and the second leading cause of cancer-related deaths. Among adults under 50, early-onset colorectal cancer is now the leading cause of cancer death in both males and females. The five-year survival rate exceeds 90% when detected early, yet over 20 million eligible Americans remain unscreened. That’s why expanding screening choices is critical – many people are reluctant or unable to undergo colonoscopy, and only half of Americans know that at-home tests are available.

The updated guidelines add several options. At-home stool tests include Cologuard (multitarget stool DNA) and ColoSense (multitarget stool RNA), both recommended every three years. A blood-based test called Shield is also included, but primarily for those who decline stool testing or colonoscopy, as it is less effective at detecting precancers. Traditional methods like FIT, gFOBT, colonoscopy every 10 years, and CT colonography remain valid choices. Experts stress that the best test is the one a person is willing to complete.

In summary, these new guidelines make colorectal cancer screening more accessible and patient-centered. By offering blood tests and convenient at-home stool options, the ACS hopes to close the screening gap, catch cancers earlier, and save more lives. The key message: start screening at 45, choose a test you can do, and always follow up a positive result with a colonoscopy. Prevention and early detection truly make all the difference.