The American Cancer Society (ACS) has updated its colorectal cancer screening guidelines to include two new options: a blood test and an at-home stool test. The changes, announced Wednesday, aim to address rising cases among younger adults and improve access to early detection. The ACS reaffirmed its recommendation for colonoscopies every 10 years for adults aged 45 to 75, but now also endorses blood-based screening tests and at-home stool tests as alternatives.
The blood test, developed by Guardant Health, detects tumor DNA in the blood and was approved by the FDA in 2024. The ACS notes that while the blood test is highly accurate for advanced cancers, it is less sensitive for precancerous lesions and early-stage cancers. Therefore, it is recommended primarily for individuals who decline or cannot complete colonoscopies or stool tests. Stool tests, such as Exact Sciences’ Cologuard and Geneoscopy’s Colosense, detect hidden blood and molecular markers of cancer with high sensitivity.
The ACS emphasizes that colorectal cancer is both preventable and treatable, with early detection improving survival rates to over 90% for early-stage cases. However, the organization highlights concerning trends, including rising cases among younger adults and disparities in screening rates among racial and ethnic groups. The new guidelines reflect advancements in detection technology and a shift in public health strategy to lower barriers to screening.
Dr. Robert Smith, senior vice president of early cancer detection science at the ACS, stated that the expanded options will help close the screening gap and catch more cancers at treatable stages. The ACS also noted that about one-third of eligible adults skip colorectal cancer screening, underscoring the need for more accessible testing methods.