If you are between 45 and 49, current guidelines put you inside the screening window for colorectal cancer.
Millions of Americans in that age band still assume they are too young to worry.
The American Cancer Society updated its colorectal cancer screening guideline on May 27, 2026, reaffirming a start age of 45 for average-risk adults.
Screening should continue through 75 for those with a life expectancy above 10 years, and is not recommended after 85.
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The guideline also expands the test menu. It adds a next-generation stool DNA test, a new stool RNA test called ColoSense, and the first FDA-approved blood test for colorectal cancer screening.
Which tests count as screening
Visual exams and stool-based tests are the preferred options. Blood-based tests are on the list but rank below them.
Test | Interval Also read: Taking an SSRI for depression? These foods and drinks may work against you |
|---|---|
Colonoscopy | Every 10 years |
CT colonography | Every 5 years Also read: The lung cells your flu shot misses may hold the key to longer-lasting protection |
Flexible sigmoidoscopy | Every 5 years |
Fecal immunochemical test (FIT) | Every year Also read: Where you live after a pregnancy may quietly shape your type 2 diabetes risk |
Multi-target stool DNA (Cologuard) | Every 3 years |
Multi-target stool RNA (ColoSense) | Every 3 years Also read: Low vitamin D may be weakening your muscles before it ever threatens your bones |
Blood test (Shield) | Every 3 years (per Medicare) |
Any positive stool or blood test must be followed by a colonoscopy, preferably within 6 months.
Skipping that step leaves the screening incomplete, and a cancer or precancerous polyp can go undetected.
Why the start age is 45, not 50
Colorectal cancer is the second leading cause of cancer death in the United States and now the number one cause of cancer-related death in adults under 50.
In 2026, an estimated 158,850 Americans will be diagnosed and 55,230 will die from the disease. Nearly half (45%) of new cases now occur in adults under 65, up from 27% in 1995.
Regular screening can cut the risk of dying from colorectal cancer because most tumors begin as slow-growing polyps that can be removed before they turn malignant. Early-stage detection is linked to a five-year survival rate above 90 percent.
Which test should you pick
Colonoscopy remains the most complete test because it lets a doctor find and remove polyps in one visit. Stool tests can be done at home and mailed to a lab.
The Shield blood test is drawn during a regular office visit, but the guideline reserves it for people who would otherwise decline any of the preferred options.
If you are 45 or older and have not talked to a clinician about screening, that is the next step. Ask which test fits your history and how to schedule it.
This article is made and published by Mie Hermansen, who may have used AI in the preparation.