The American Cancer Society (ACS) has reaffirmed that average-risk adults should begin colorectal cancer screening at age 45 and continue through age 75, while incorporating newly approved stool-based and blood-based screening technologies into its updated guidance.
The ACS continues to favor stool-based tests, including next-generation stool DNA and stool RNA assays, citing their strong ability to detect colorectal cancer and precancerous lesions. In contrast, blood-based screening tests demonstrated lower sensitivity for early-stage cancers and advanced precancerous lesions and are recommended primarily for individuals who decline or do not complete preferred screening options.
Importantly, the guideline reinforces that screening participation matters most: offering multiple screening choices may improve adherence because “the best screening test is the one that gets completed.” However, any positive non-colonoscopy screening result should be followed by a colonoscopy—preferably within six months—to complete the screening process and enable cancer prevention through polyp detection and removal.