American Cancer Society Updates Colorectal Screening Guidelines to Include Blood and Stool Tests

The American Cancer Society updated its colorectal cancer screening guidelines Tuesday, formally endorsing blood-based and stool-based tests as alternatives to colonoscopies for average-risk adults.

The updated guidelines recognize several newer tests, including the Shield blood test and the Cologuard stool DNA test, as acceptable screening options. Doctors say the change could significantly increase the number of people who get screened.

Colorectal cancer is the second leading cause of cancer death in the United States. About one in three adults who should be screened are not getting tested, often because they want to avoid the colonoscopy preparation process.

"We want to remove every barrier we can," said Dr. William Dahut, chief scientific officer at the American Cancer Society. "If a blood test gets more people screened, that saves lives."

The guidelines still recommend colonoscopies as the preferred option because they can detect and remove polyps in a single procedure. But the society now says any approved screening test is better than no screening at all.

The update comes as several new blood-based tests have received FDA approval or are in late-stage clinical trials. Insurance coverage for these tests varies, and advocates are pushing for broader coverage under Medicare and private plans.

Adults at average risk should begin screening at age 45, according to the guidelines.