American Cancer Society colorectal cancer screening updates

The American Cancer Society (ACS) has updated its colorectal cancer screening guidelines to include blood tests as an optional method for individuals at average risk. This update reflects advancements in molecular biology, such as the detection of methylation patterns and genomic alterations associated with neoplasia.

While the ACS acknowledges the convenience of blood draws, the organization emphasizes that these tests are not the preferred screening method due to lower sensitivity compared to imaging and high-accuracy stool tests, particularly regarding stage I cancers and precancerous polyps. The primary objective remains disease prevention through early polyp removal.

Recent developments supporting these changes include the 2024 FDA approval of Guardant Health’s Shield and the anticipated approval of Freenome’s SimpleScreen in July 2026. In contrast to the US updates, German medical guidelines continue to endorse colonoscopy and fecal immunochemical tests (FIT) as the gold standards, noting that blood-based tests are less reliable for identifying advanced adenomas.