- Posted May 28, 2026
New Colon Cancer Screening Guidelines Add Blood And At-Home Tests
Blood tests taken in a doctor’s office now can be used to screen for colon cancer, according to updated American Cancer Society (ACS) guidelines.
The new guidelines also recommend Cologuard, an at-home test that looks for both blood and cancer DNA in a person’s stool.
The move comes as experts try to expand screening for colon cancer and further drive down rates for the disease, researchers said.
“We need to increase our emphasis on colorectal cancer as a highly preventable disease as much as a treatable one,” said senior researcher Robert Smith, senior vice president for early cancer detection science at ACS.
“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,” Smith said in a news release.
Colon cancer is one of the few cancers that can be prevented, if doctors are able to detect and remove pre-cancerous polyps inside the colon, researchers said. Early detection yields five-year survival rates of more than 90% in the U.S., according to ACS.
However, 1 out of 3 Americans eligible for colon cancer screening have not been tested, amounting to more than 20 million adults, researchers said.
What’s more, although overall colon cancer rates and deaths have steadily declined over the years, there’s been a recent increase in rates among people younger than 50, researchers noted.
In fact, colon cancer is now the top cancer killer of adults under 50, researchers said.
Colonoscopy remains the gold standard for colon cancer screening. A thin, flexible tube is run up into a person’s colon while they are sedated, giving doctors a chance to find and even remove pre-cancerous polyps.
But many people find prep for colonoscopy too unpleasant, as powerful laxatives are used to clean out the colon for examination. Others are daunted by the idea of sedation.
That’s why the ACS has broadened screening options to include fecal tests – including at-home tests like Cologuard – and, now, blood tests.
The blood test – brand name Shield – can detect cancer DNA in a person’s blood that’s been shed by a tumor. It doesn’t work as well in detecting pre-cancerous polyps or early cancers, but it’s better than no screening at all, experts said.
The U.S. Food and Drug Administration (FDA) approved the blood test in 2024, according to the National Cancer Institute.
The blood test and standard fecal testing should be done every year, the new guidelines said. DNA-based fecal tests like Cologuard can be taken every three years.
CT “virtual” colonoscopy can be done every five years, as can flexible sigmoidoscopy – a procedure similar to colonoscopy that only examines the lower third of the colon, the guidelines said.
People who get a full colonoscopy only need to be tested every 10 years, according to guidelines.
Screening should start at 45, or earlier if a person has an elevated risk of colon cancer. People can stop getting screened after age 85.
“No matter which test you choose, what’s most important is to get screened, and that includes underserved, rural and minority populations,” said Dr. William Dahut, chief scientific officer at the American Cancer Society.
“These changes were developed to add to the colorectal cancer screening arsenal and help ensure preventive cancer care is available to all,” he said in the release.
It’s crucial that people who undergo non-invasive screening get a follow-up colonoscopy if their test returns abnormal results, researchers emphasized.
The ACS’s advocacy affiliate, the American Cancer Society Cancer Action Network (ACS CAN), is working to expand access to both initial testing and follow-up care.
“Expanding screening options only matters if people can actually access them,” said Lisa Lacasse, president of ACS CAN.
“Coverage and affordability remain among the biggest factors in whether eligible individuals get screened for colorectal cancer,” she said in the release. “ACS CAN will continue pressing for policies that eliminate out-of-pocket costs and other barriers, so everyone has a fair opportunity to get the evidence-based screening they need.”
The new guidelines appear in CA: A Cancer Journal for Clinicians, the flagship journal of the ACS.
More information
American Cancer Society has a patient page explaining the new guidelines.
SOURCES: American Cancer Society, news release, May 27, 2026; CA: A Cancer Journal for Clinicians, May 27, 2026
