The American Cancer Society updated its colorectal cancer screening guidelines to include new blood and stool-based tests, the organization announced on May 27, 2026. The move adds alternatives to colonoscopy for the first time in years and is aimed at getting more people screened.
According to Healthline, the updated guidelines still keep the ACS recommendation to begin colorectal cancer screening at age 45. Colonoscopies every 10 years remain on the list for people at average risk. But the new guidelines recognize advances in disease detection and reflect a broader effort to lower barriers to access.
"We need to increase our emphasis on colorectal cancer as a highly preventable disease as much as a treatable one," said an ACS official quoted in the report. "By offering more screening tools in our guideline update, more eligible adults will be able to participate in lifesaving colorectal cancer testing, helping to close the screening gap and catch more cancers at an earlier, treatable stage."
Two at-home stool sample tests are included in the updated guidelines. The first is an updated version of a test sold under the brand name Cologuard, which analyzes stool samples for specific DNA markers and hemoglobin. The second is a newer test sold under the brand name ColoSense, which analyzes stool samples for RNA markers and hemoglobin. Both tests are recommended every three years for people over 45 with average risk. According to the ACS report, both tests demonstrate high sensitivity for colorectal cancer and moderate sensitivity for advanced precancerous lesions.
The guidelines also include a blood-based test sold under the brand name Shield. Federal regulators approved the test in 2024. It is designed to detect tumor DNA in the blood.
Physicians not involved in drafting the report said expanding the options was a step in the right direction. Babak Firoozi, a gastroenterologist at MemorialCare Orange Coast Medical Center in California, told Healthline, "I definitely think that presenting more options is better. It helps to have these available. It's important to increase the number of people who are being screened anyway we can."
Anton Bilchik, a surgical oncologist and director of the Gastrointestinal and Hepatobiliary Program at Providence Saint John's Cancer Institute in California, also weighed in. "There are so many people who don't have access or don't want to do a colonoscopy screening," he said. "This really will increase the number of people willing to get screened."
The ACS said the guidelines reflect both the availability of new detection technology and the continued rise in colorectal cancer rates among adults under 50, a trend that has driven urgency around earlier and more accessible screening options. The guidelines were published in a peer-reviewed journal on May 27.
