In this perspective, Dr. Aasma Shaukat contends that the American Cancer Society’s updated colorectal cancer screening guideline strikes the right scientific balance by classifying blood-based screening tests as “non-preferred” options. However, she believes the guideline falls short because it does not provide practical implementation guidance to ensure these tests remain secondary choices rather than becoming routine first-line screening.
She explains that once a screening test is included in a major guideline, many patients, clinicians, health systems, payers, and the media are likely to interpret that inclusion as an endorsement. Without clear operational guardrails, blood-based tests—which are intended only for average-risk individuals who decline or fail to complete colonoscopy or stool-based screening—could increasingly replace more effective screening methods simply because they are easier and more convenient.