Colorectal Cancer
The American Cancer Society (ACS) 2026 colorectal cancer (CRC) screening guideline reaffirms the recommendation that average-risk adults should initiate CRC screening at age 45 years and continue through age 75 years for those with a life expectancy greater than 10 years. Average-risk adults age 76-85 should discuss with their health care provider whether continuing screening makes sense. Those older than 85, or with a life expectancy of fewer than 10 years, should not continue screening.
Visual exams (most commonly colonoscopy) and stool-based tests are recommended and preferred for screening. New blood-based tests are also among the recommended tests, but they are not a preferred option at this time. This is because research shows they are less likely to find precancerous growths and early-stage cancer (Stage I).
As a part of the screening process, all positive results on non-colonoscopy screening tests should be followed up with timely colonoscopy.
Consistent with prior guidelines, the ACS emphasizes that offering multiple recommended screening options supports informed patient choice and may improve participation, because the most effective screening test is the one that the patient completes.
