In recent years, it’s become more common for headlines to mention the increase in colorectal carcinoma among young adults. The American Cancer Society made a decision in 2018 to lower the age recommended for screenings based on average risk from 50 years old to 45. This was due to the increasing incidence of colorectal carcinoma among people younger than 50.
The society, riding on the increasing awareness about colorectal carcinoma in the public, has released new screening guidelines for May 2026 that include the latest tests and can improve access to healthcare.
As a researcher in public health, I have spent the last 20 years researching ways to improve guidelines for screening and developing programs that prevent colorectal carcinoma.
More options in screening may help to detect cancer sooner or even prevent it.
What is new in the revised screening guidelines?
Two new screening options have been added to the updated guidelines.
First, you can perform a screening at home to check for molecular markers and hidden blood in stool samples that could indicate colorectal carcinoma.
These tests should be taken every three years, according to the guidelines.
Another option would be a blood test, which can be performed in a doctor’s office. This test is available to patients who do not want a colonoscopy, or refuse the stool-based test.
The updated guidelines offer a patient the choice of a stool sample or a visual examination – like a colonoscopy as the primary method for screening.
Speak to your doctor if you notice any of these symptoms.
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Adults with an average colorectal risk should also start getting screened at 45 and continue screening until 75, or if a doctor recommends it, even beyond.
What is the best colorectal screening test?
A colonoscopy should be performed for people who have a history of colorectal or other cancers, or genetic syndromes or symptoms such as bloody stools.
Your doctor might recommend stool and blood tests if you’re 45 years old and have a normal risk. These are relatively new tests, so many doctors’ offices might not offer them immediately.
The best test, in the end, is one which gets completed.
Do I need a colonoscopy if I have a stool or blood test?
The preferred colorectal screening test is still the colonoscopy.
The only choice for people who have colorectal symptoms and are considered at higher risk is a colonoscopy. Even those with a low risk of colorectal cancer may be advised to undergo a colonoscopy.
Will Smith documents his first colonoscopy.
The stool tests are used widely because they do not need the same preparation as colonoscopies.
New stool tests are better able to detect polyps or abnormal cells.
Only if the patient has refused a colonoscopy, or stool tests is a new blood test recommended. The new tests do not have the same sensitivity as other cancer prevention tests, but science continues to advance and provide more options.
Bottom line: If a stool test or a blood test shows abnormal results, a colonoscopy is also required.
Early symptoms of colon cancer
Colorectal Cancer is often not a disease that shows early symptoms. Therefore, screening should begin at 45 years old, especially for those with a history of the condition or a genetic predisposition.
Colorectal Cancer symptoms include pain or an unexplained loss of weight of more than 10 pounds.
Talk to your doctor if you experience these symptoms regardless of age and ask for a colonoscopy.
What can I do to reduce my colon cancer risk?
People at an average risk for colorectal disease can reduce their risk by starting screenings at 45 years old.
Attention to the body Be aware of any changes in your body and talk to your doctor about them.
A healthy lifestyle can help you reduce your colorectal-cancer risk. It is important to get at least 30 minutes daily of exercise, eat a healthy diet with plenty of fruits and vegetables, and limit processed food. Reduce your alcohol consumption and avoid smoking or vaping to reduce your cancer risk.
