People who put off colon cancer screening because they want to avoid a colonoscopy may now have another option.
The American Cancer Society (ACS) has updated its screening guidelines to include blood-based testing for some adults at average risk of colorectal cancer — a move aimed at reaching people who avoid more traditional screening methods.
The new recommendation applies to adults 45 and older who are considered average risk and who decline or do not complete preferred screening options.
The change comes as colorectal cancer continues to appear more frequently in younger adults. According to the ACS, nearly half of new colorectal cancer cases occur in adults younger than 65, and roughly 1 in 10 cases are diagnosed before age 50. It is now the leading cause of cancer-related deaths among adults under 50.
At the same time, screening rates remain a problem. The Colon Cancer Coalition estimates roughly one-third of eligible adults are not getting screened as recommended.
What‘s changing?
Colonoscopies remain the preferred option and are still considered the most effective way to detect colorectal cancer because doctors can identify and remove potentially dangerous polyps during the same procedure.
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Colorectal cancer is the leading cause of cancer deaths in adults under the age of 50, according to the American Cancer Society.
But for people unwilling or unable to undergo a colonoscopy or complete stool-based testing, the ACS now says blood testing can be another option.
The organization specifically recommends the Shield blood test from Guardant Health, which received FDA approval in 2024.
The ACS says blood testing should currently be used only for people who decline or do not complete preferred screening methods because the tests are less effective at finding precancerous polyps.
“There are a lot of people who can’t or won’t do a colonoscopy, or the idea of collecting their own stool for testing, they just won’t do,” ACS Chief Science Officer, Dr. William Dahut, said. “Having more options hopefully will allow more people to be screened to find cancers earlier on, and we’ll be able to cure more patients.”
What other screening options exist?
People at average risk are advised to begin screening at age 45.
Colonoscopies, generally performed every 10 years, remain the most comprehensive option. Other screening choices include stool-based testing every one to three years, depending on the test, as well as visual exams such as virtual colonoscopies or sigmoidoscopies.
People with a personal history of polyps, inflammatory bowel disease or a family history of colorectal cancer may need earlier or more frequent screening.
Why screening matters
Many colorectal cancers begin as polyps, which can often be detected and removed before becoming cancerous.
According to the Colon Cancer Coalition, more than 90% of patients whose colorectal cancer is detected at stages I or II survive at least five years.
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