New guidelines could help millions more Americans get colon cancer testing

The American Cancer Society (ACS) has expanded colon cancer screening guidelines to include new options beyond colonoscopies and traditional stool tests. Starting at age 45, people at average risk should undergo screening through age 75 if they have a life expectancy of at least 10 years, with colonoscopy remaining the gold standard. The updated guidelines now include a blood-based test performed in a doctor’s office and two new stool sample kits, including an FDA-approved at-home test detecting blood and molecular markers in stool samples. The changes aim to address gaps in screening, as over 20 million eligible Americans remain unscreened. Experts emphasize that the most effective test is the one patients will complete, with blood tests recommended only for those unable or unwilling to undergo other methods due to their lower detection rates. Colonoscopies should be repeated every 10 years, while other tests vary in frequency—every one, three, or five years, depending on the method. Colon cancer rates are rising among younger adults, with 1 in 5 new cases now affecting people under 55, compared to 1 in 10 in the mid-1990s. The ACS hopes expanded options, including at-home tests, will encourage more people to get screened without needing time off work or invasive procedures. Dr. William Dahut, ACS chief scientific officer, stressed the guidelines apply only to average-risk individuals without symptoms or family history, advising symptomatic patients to seek immediate medical evaluation. The ACS recommends consulting healthcare providers to determine the best test and checking insurance coverage. Symptoms like blood in stool, persistent abdominal pain, or changes in bowel habits should prompt further medical assessment rather than relying on blood or stool tests alone.