The American Cancer Society has updated its colorectal cancer screening guidelines to include blood-based tests alongside traditional colonoscopy and stool-based screening methods. The updated guidelines represent the first major revision in screening recommendations since 2018, reflecting advances in screening technology and efforts to improve access to early detection.
Colorectal Cancer Screening Methods Now Include Multiple Options
American Cancer Society approved screening approaches, 2024 guidelines
colonoscopies
stool tests
blood tests
Source: American Cancer Society, 2024 | Georgian Medical Journal News
Blood Tests Gain Equal Standing with Traditional Methods
The most significant change in the updated guidelines is the inclusion of blood-based screening tests as a primary screening option. According to the American Cancer Society, these tests can detect circulating tumor DNA and other biomarkers associated with colorectal cancer. The guidelines recommend blood-based screening every one to three years, though the exact interval depends on the specific test used.
Dr. William Dahut, chief scientific officer at the American Cancer Society, emphasized that the goal is to increase screening participation rates. “We want to remove barriers and provide multiple options that people can choose from based on their preferences and circumstances,” Dahut stated in the organization’s announcement. The clinical implications extend beyond convenience, potentially reaching populations who have avoided traditional screening methods.
Stool-Based Testing Maintains Important Role
Stool-based tests, including fecal immunochemical tests (FIT) and multitarget stool DNA tests, remain recommended screening options under the updated guidelines. The Centers for Disease Control and Prevention reports that these non-invasive tests have helped increase screening rates in recent years. The American Cancer Society recommends annual FIT testing or multitarget stool DNA testing every one to three years.
The guidelines maintain that positive results from stool or blood tests require follow-up colonoscopy for definitive diagnosis and treatment. This creates a tiered approach where less invasive initial screening can identify high-risk individuals who then receive more comprehensive evaluation through direct visualization methods.
Colonoscopy Remains Gold Standard Despite New Options
While expanding screening options, the guidelines continue to position colonoscopy as the most comprehensive screening method. The American Gastroenterological Association supports this approach, noting that colonoscopy can both detect and remove precancerous polyps during the same procedure. The recommended interval remains every 10 years for average-risk individuals.
The updated guidelines also address screening frequency and age recommendations, maintaining the 2018 recommendation to begin screening at age 45 for average-risk individuals. This reflects the increasing incidence of colorectal cancer in younger adults, a trend that has prompted earlier screening recommendations across medical organizations.
Implementation Challenges and Access Considerations
Healthcare systems now face the challenge of implementing multiple screening pathways while ensuring appropriate follow-up for positive results. The guidelines emphasize that screening programs must have systems in place to track results and ensure that individuals with positive blood or stool tests receive timely colonoscopy. Insurance coverage and cost considerations may also influence which screening methods become widely adopted in clinical practice.
The updated guidelines aim to increase screening participation by offering multiple evidence-based options, addressing the reality that approximately one-third of eligible adults are not up to date with colorectal cancer screening.
— American Cancer Society Guidelines Committee (CA: A Cancer Journal for Clinicians, 2024)
Key takeaways
- Blood-based screening tests are now recommended as primary screening options alongside colonoscopy and stool tests
- Multiple screening pathways aim to increase participation rates and remove barriers to early detection
- All positive blood and stool test results require follow-up colonoscopy for definitive diagnosis
- Screening should begin at age 45 for average-risk individuals across all approved methods
Frequently asked questions
How accurate are blood tests compared to colonoscopy for colorectal cancer screening?
Blood-based tests are less sensitive than colonoscopy but offer improved convenience and may increase screening participation. The American Cancer Society included them based on evidence showing they can detect clinically significant cancers, though colonoscopy remains the most comprehensive option.
Do insurance plans cover the new blood-based screening tests?
Coverage varies by insurance plan and specific test. The Affordable Care Act requires coverage of recommended preventive services, but implementation of new guidelines may take time to reflect in insurance policies.
How often should someone get screened if they choose blood-based testing?
The guidelines recommend blood-based screening every one to three years, with the specific interval depending on the test used and individual risk factors. Healthcare providers should determine the appropriate frequency for each patient.
The expansion of colorectal cancer screening options represents a significant shift toward personalized prevention strategies that accommodate different patient preferences and circumstances. As healthcare systems adapt to implement these multiple screening pathways, the success of these updated guidelines will ultimately be measured by their ability to increase screening participation and reduce colorectal cancer mortality through earlier detection.
Source: Poop tests and blood tests join colonoscopy as options for colorectal cancer screening
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Medically reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD. Spotted an error? Contact the editorial team.
