Cáncer de colon is the third most common cancer diagnosed in the United States, but it is also one of the most preventable and, when found early, most treatable forms of cancer.
According to the Sociedad Americana del Cáncer (ACS), an estimated 158,850 new cases of colorectal cancer will be diagnosed in 2026. Over a third of those cases will be fatal. Colorectal cancer is the second most common cause of cancer deaths for both men and women.
But here's the encouraging reality: most of those deaths don't have to happen. Colon cancer caught in its earliest stages has a five-year survival rate of more than 90%. Screening saves lives, and today there are more options than ever to make it easier, more accessible and less intimidating to get started.
So, what's changed in colon cancer screenings and when should you get tested? Let's take a closer look.
One of the most relevant shifts in how doctors think about colorectal cancer today involves who is being diagnosed. While rates have steadily declined in adults over 65, largely thanks to increased screening over the past few decades, the opposite trend is emerging in younger adults.
Colorectal cancer incidence is rising by 3% per year in adults aged 20 to 49 and by 0.4% per year in those aged 50 to 64. Nearly half of all new colorectal cancer cases now occur in people under 65, up from just 27% in 1995. Even more striking is that colorectal cancer is now the leading cause of cancer-related death in adults under 50 in the United States.
Researchers are still working to understand why. Contributing factors likely include:
What's clear is that younger adults, including millennials and Gen Z, need to be aware that this condition is no longer something to think about later.
Related: Cómo prevenir el cáncer de colon: Hábitos saludables para los millennials
The answer for most adults is at age 45.
The American Cancer Society recommends that all average-risk adults begin regular Detección de cáncer de colon at age 45 and continue through age 75 for those in good health. For adults between 76 and 85, screening decisions should be made with your physician based on your individual health, life expectancy and prior screening history. Adults over 85 are generally no longer advised to continue routine screening.
If you have any of the following risk factors, your doctor may recommend starting screening earlier or more frequently:
If you're unsure about your risk level, your primary care doctor or a gastroenterologist can help you figure out the right starting point and schedule.
When it comes to colorectal cancer screenings, the best test is the one you actually do. Whether you prefer a procedure at a clinic or hospital or a simple test you complete at home, there's a legitimate, medically recognized colon cancer screening option for you.
In mayo 2026, the American Cancer Society released an updated version of its colorectal cancer screening guidelines. The revision doesn't upend the fundamentals; colonoscopy remains the gold standard, and the recommended starting age of 45 holds firm, but it does expand the options available, now formally including a blood-based screening test. This is an ideal option for those who have been hesitant to pursue traditional testing.
Here's a breakdown of the options when it comes to screening for colon cancer:
A Colonoscopia remains the only screening method that is both diagnostic and preventive. During the procedure, the entire colon is examined and precancerous polyps can be removed on the spot, preventing them from ever developing into cancer. For average-risk adults, it's typically only needed once every 10 years if your results are normal.
Colonoscopy requires bowel preparation beforehand and is performed under sedation. These factors cause some people to delay or even avoid it. However, most people remember little or nothing about the procedure itself and are able to return to their normal activities the next day. Learn what to expect at a colonoscopy and why it’s not that bad.
Stool-based tests are noninvasive, typically done at home and require no time off from work. They are highly accurate for detecting colorectal cancer in average-risk adults, but are less effective than a colonoscopy at catching precancerous polyps. Any positive result from a stool-based test should be followed up promptly with a colonoscopy, ideally within six months.
For the first time, the 2026 ACS guidelines include an FDA-approved blood-based screening test, called Shield, as a formal option. This test detects tumor DNA circulating in the bloodstream.
Compared to established stool-based tests, this new blood-based test demonstrates lower sensitivity for detecting early-stage cancers and precancerous lesions, which may limit their ability to prevent colorectal cancer from developing.
While this new option is intended primarily for people who decline or don't complete stool-based or visual screening tests, it is still considered a meaningful step forward in access and convenience, and any positive result should be followed up with a colonoscopy.
| Screening test | Cómo funciona | How often* | PROS | Things to know |
|---|---|---|---|---|
| Colonoscopia | Uses a thin, flexible tube with a camera to examine the entire colon and remove polyps if needed. | Every 10 years for people at average risk | Can both find and remove precancerous polyps during the same procedure. | Requires bowel preparation and sedation for most people. |
| Prueba de ADN en heces | Uses a stool sample collected at home to look for blood and certain DNA changes linked to colon cancer. | Every 3 years | No bowel prep or sedation; can be done at home. | If results are abnormal, you'll need a colonoscopy. |
| Prueba inmunoquímica fecal (FIT) | Checks a stool sample for tiny amounts of blood that may not be visible. | TODOS LOS AÑOS | Quick, easy and done at home. | An abnormal result requires a follow-up colonoscopy. |
| Prueba guayacol de sangre oculta en heces (gFOBT) | Looks for hidden blood in the stool using a chemical test. | TODOS LOS AÑOS | Noninvasive and can be completed at home. | Certain foods and medications may affect results. A positive test requires a colonoscopy. |
| Flexible sigmoidoscopy + FIT | Combines a sigmoidoscopy, which examines only the lower third of the colon, with an annual stool test. | Sigmoidoscopy every 10 years plus yearly FIT | Provides additional screening without a full colonoscopy. | Abnormal findings may require a colonoscopy. |
| Shield blood test | A blood test that looks for DNA changes in the bloodstream that may be linked to colorectal cancer. | Every 3 years | Requires only a blood draw and can be completed during a routine office visit. | Less effective at finding precancerous polyps than colonoscopy. Any positive result should be followed by a colonoscopy. |
*Screening intervals are general recommendations for adults at average risk. Your doctor may recommend a different schedule based on your personal or family history.
Colorectal cancer often develops without any obvious symptoms in its early stages, which is one of the core arguments for screening in the first place. But there are some common symptoms of colon cancer that should prompt a conversation with your doctor at any age:
None of these symptoms automatically indicate cancer, and most have more common explanations. Still, if something is new or persisting, it's always worth a conversation with your doctor.
Screening is the most effective tool for catching colorectal cancer early, but your day-to-day choices also play an essential role. Many lifestyle factors have been linked to colorectal cancer risk, and are within your control:
Despite robust screening options and strong evidence for their effectiveness, an estimated 1 in 3 eligible adults in the United States are not up to date on their colorectal cancer screening. That’s one-third of people not getting screened who should be.
More people getting screened at the right age, with the right test for their situation, is the single most impactful thing that can shift these numbers. Most colorectal cancers develop slowly over several years, which means screening often finds problems before they become cancer or catches cancer when it's highly treatable.
Whether you choose a colonoscopy, an at-home stool test or one of the newer options now available, what matters most is that you make a choice and follow through.
Talk to your doctor about your personal risk factors, your family history and which screening method makes the most sense for you. And if you haven't started yet and you're age 45 or older, book an appointment with your primary care provider.
David Winter, MD, es médico de medicina interna en el personal médico de Baylor Scott & White Signature Medicine - Tom Landry.
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