The American Cancer Society has updated its colorectal cancer screening guidance, reaffirming that average-risk adults should begin screening at age 45 and continue through age 75. The update also incorporates several newly approved screening technologies, including stool RNA, next-generation stool DNA, and blood-based tests.
The ACS continues to favor stool-based screening options, noting that next-generation stool DNA and stool RNA tests demonstrated strong colorectal cancer detection rates and moderate sensitivity for advanced precancerous lesions. In contrast, blood-based screening tests showed lower sensitivity for both early-stage cancers and precancerous lesions, leading the ACS to recommend them primarily for individuals who decline or do not complete preferred screening methods.
The guideline also reinforces a key message in CRC prevention: the best screening test is the one a patient completes. Regardless of the screening method used, any positive non-colonoscopy result should be followed by a colonoscopy—ideally within six months—to complete the screening process.