Colorectal cancer screening: What are my options?

There are a number of ways to screen for this cancer. Choosing the right test starts with knowing what’s available.

Aug. 07, 2026

You’re doing all the right things: You exercise, eat well and get enough sleep every night. But if you are 45 or older, you may be missing a critical part of your preventive care — and you wouldn’t be alone.

Nearly 60 million people are eligible to screen for colorectal cancer (CRC),1 the second-leading cause of cancer-related deaths in the U.S.2 — and it’s on the rise in people under 50.3

The good news: “Colorectal cancer is typically much easier to effectively treat, and potentially even cure, when caught early,” says Paul Limburg, MD, MPH, a chief medical officer at Abbott. “Beyond keeping up with healthy habits, regular screening is one of the best ways to defend against the disease.”

Understanding how you can get screened is the first step.

So, how can I get screened for colorectal cancer?

The American Cancer Society (ACS) publishes a guideline that explains how people who are at average risk for colorectal cancer can safely and effectively get screened.5 ACS recommends screening by visual exam, like a colonoscopy, or by using a stool-based test for the best chance of cancer prevention and early detection. In May 2026, ACS added another option, blood-based testing, for those unwilling to screen with preferred methods.

Each screening method — visual exam, stool-based tests, and blood-based tests — differs on features like rate of detection, ability to catch pre-cancer, comfort, convenience, follow-up and screening interval.

Becoming familiar with the differences between screening methods can help ensure you and your doctor choose the right test for you. Here are a few things to consider when evaluating each screening method:

Category: Visual exam

Example: Colonoscopy

Features5

  • ACS-preferred screening option
  • Highly effective at detecting and removing cancer
  • Highly effective at detecting and removing and pre-cancer
  • Invasive; requires special prep, sedation, and internal examination
  • Outpatient procedure
  • Can be difficult to schedule, as capacity is limited4 and the procedure often requires time away from work or other responsibilities
  • Required after abnormal result from all other screening methods
  • Screen again in 10 years after a negative result

Category: Stool-based tests

Example: Cologuard Plus

Features5

  • ACS-preferred screening option
  • FDA-approved to be safe and effective in finding cancer
  • FDA-approved to detect pre-cancer
  • Noninvasive; no special prep, sedation or internal examination
  • Stool sample can be collected at home
  • Can be completed on your own time
  • Positive test result requires follow-up colonoscopy
  • Screen again in 3 years after a negative result

Category: Blood-based tests

Example: SimpleScreen CRC

Features5

  • Recommended by guidelines when preferred screening options are declined
  • FDA-approved to be safe and effective in finding cancer
  • Limited detection of stage 1 and precancer
  • Minimally invasive blood draw; no special prep, sedation, or internal examination
  • Blood sample can be collected at your doctor’s office, at a nearby lab or at home via mobile phlebotomy
  • Can be completed on your own time
  • Positive test result requires follow-up colonoscopy
  • Screen again in 3 years after a negative result

Why should blood tests only be used if other colorectal cancer screening options are declined?

In the most recent guideline, ACS says that blood tests are “not preferred.” Colorectal cancer blood tests should only be used if you’re not willing to do a stool-based test or visual exam, because those tests are better at catching pre-cancer and early-stage colon cancer.5 That said, using a blood test is better than not screening for CRC at all.

When do I need to start screening for colorectal cancer?

Average-risk adults should begin colorectal cancer screening at age 45, according to ACS.5 Screening should continue until age 75 or beyond, depending on your health and other factors. Note that screening guidelines may be different for high-risk individuals. It’s a good idea to talk to your doctor, who can help you evaluate your risk and stay current on screening.

How do I choose the right screening test for me?

If you’re 45 or older and at average risk for colorectal cancer, there’s no time like the present to get screened. Here are some questions you can ask your doctor to help determine the right screening method for you:

  • How well does this test find cancer?
  • Can this test find pre-cancer?
  • What does it take to complete the test?
  • How often do I have to screen with this test?
  • Is this test covered by my insurance?

“There are multiple options for average-risk colorectal cancer screening, but they don’t all perform equally, particularly with respect to detecting early-stage cancers and precancers,” says Dr. Limburg. “It’s important to understand the characteristics of each available test, chose the one that’s right for you, and commit to completing not only the initial screening but also the recommended follow-up.”

References

1 Ebner DW, Kisiel JB, Fendrick AM, et al. Estimated Average-Risk Colorectal Cancer Screening-Eligible Population in the US. JAMA Netw Open. 2024;7:e245537.

2 Siegel RL, Kratzer TB, Wagle NS, et al. Cancer Statics, 2026. CA Cancer J Clin. 2026;e70043.

3 Siegel RL, Jemal A, Ward EM. Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomarkers Prev. 2009:18(6):1695-1698.

4 Joseph DA, Meester RG, Zauber AG, et al. Colorectal cancer screening: Estimated future colonoscopy need and current volume and capacity. Cancer. 2016;122:2479-86.

5 Wolf AMD, Hoffman RM, Walter LC, et al. Colorectal cancer screening: an update to the American Cancer Society guideline, 2026. CA Cancer J Clin. 2026;e70083.

Important safety information

Important Information about the Cologuard products

The Cologuard test and Cologuard Plus test are indicated to screen adults, 45 years or older, who are at average risk for CRC. A positive result may indicate the presence of colorectal cancer (CRC) or advanced precancerous lesions (APL) and should be followed by a colonoscopy. Not a replacement for colonoscopy in high-risk individuals. False positive and negative results may occur. Rx only. See more at Cologuard.com/risk-information.

Important Information about the SimpleScreen CRC test

The SimpleScreen CRC test is indicated for colorectal cancer (CRC) screening in adults aged 45 years and older who are at average risk for CRC. A positive result should be followed by a colonoscopy. Not a replacement for colonoscopy in high-risk individuals. False positive and negative results may occur.

Precaution: Based on data from clinical studies, SimpleScreen CRC has limited detection of Stage I (57%) colorectal cancer (64% when U.S. 2020 Census age-sex adjusted) and does not detect 87% of advanced precancerous lesions (86% when U.S. 2020 Census age-sex adjusted). One out of 10 patients with a negative SimpleScreen CRC result may have a precancer that would have been detected by a screening colonoscopy.

Rx only. Developed and manufactured by Freenome, LLC. Distributed by Abbott.

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