The American Cancer Society (ACS) announced updated colorectal cancer screening guidelines on May 13, 2026, adding three new tests to its recommendations: one blood-based test and two enhanced stool tests, Cologuard Plus and ColoSense [1, 2]. These additions aim to increase screening rates among US adults aged 45 to 75, amid rising colorectal cancer cases in younger adults [1, 2].
Cologuard Plus detects tumor DNA and cell-free DNA in stool, while ColoSense identifies cancer RNA, making both more sensitive than earlier stool tests [1]. The blood test, designed to detect tumor DNA in the bloodstream, can be performed during a doctor’s office visit [2]. These options complement traditional colonoscopy, which remains the gold standard for screening due to its ability to directly examine and remove suspicious tissue but has barriers such as required bowel prep and sedation [1].
ACS recommends colorectal cancer screening for average-risk adults from age 45 to 75 with a life expectancy over 10 years. Screening usually stops after age 85. High-risk individuals may require earlier or more frequent testing [2]. Despite these guidelines, less than half of US adults aged 45 to 49 have completed recommended screening, even as diagnoses increased by 50% in this group between 2021 and 2022 [1, 2].
Early detection significantly improves outcomes. The five-year survival rate for early-stage colorectal cancer in the US exceeds 90% [2]. Robert Smith of ACS said, "People should be getting screening as soon as they are eligible. We always say the best test is the one you get." He added the new guidelines offer "more screening tools" to help close the gap and catch cancers earlier [1, 2]. William Dahut emphasized that "no matter which test you choose, what’s most important is to get screened, and that includes underserved, rural and minority populations." [2]
The ACS plans to monitor screening uptake and outcomes as providers and patients adopt the new testing options.
