The American College of Gastroenterology and the American Gastroenterological Association have issued statements highlighting some concerns and important factors to consider as new colorectal cancer screening guidance from the American Cancer Society draws attention to the growing number of testing options.
Although the ACS did not list blood-based tests as a preferred option (Table), noting that these tests have “demonstrated lower sensitivity for both advanced precancerous lesions and stage I cancers, with modeling studies predicting less effectiveness in reducing CRC incidence and mortality,” they left the door open for use of such tests for some patients: “individuals who decline or do not complete preferred screening tests” (CA Cancer J Clin 2026;76[3]:e70083).
This language has the gastroenterology societies concerned.
In a statement, the ACG noted that it supports the ACS’s aim of improving CRC screening rates among unscreened individuals but wants “to be certain that the unscreened individuals are given a genuine opportunity to complete a ‘preferred’ test first, before being offered a blood test.” Substituting a blood test in place of a “preferred” test “poses serious risks to patients due to its low sensitivity for detecting precancerous polyps and early-stage cancers.”