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Finding and removing polyps before they become cancer. Colonoscopy prevents cancer; stool and blood tests catch it early and get more people screened.
Colonoscopy every 10 years (finds and removes adenomas), annual FIT, multitarget stool DNA (Cologuard, every 3 years), CT colonography, and since 2024 the Shield blood test (83% sensitivity for cancer, low for advanced adenomas). USPSTF lowered the start age to 45 in 2021 as early-onset CRC rises. Screening is credited with much of the fall in CRC mortality in over-65s; uptake in 45-49-year-olds is low.
Detect adenomas or early cancers by direct visualisation (endoscopy), occult blood or shed DNA in stool, or cfDNA methylation and fragmentation in blood.
A home stool test done every three years that looks for cancer DNA and hidden blood; a positive result means you need a colonoscopy.
The updated Cologuard, approved in 2024, which keeps the high cancer detection rate while causing fewer false alarms.
The second FDA-approved blood test for bowel cancer screening, from Freenome, sold by Abbott from late 2026.
This is the validation study behind the July 2026 FDA approval of SimpleScreen CRC. For someone who will not take a stool test or colonoscopy it offers a real option for catching cancer, but because it misses most advanced polyps it prevents fewer cancers than the established tests, and a positive result still needs a colonoscopy.
The numbers behind the argument that the screening programme is working for the people it covers and failing everyone below its start age; the stage shift going into reverse is the most uncomfortable figure on this roadmap.
A colonoscopy probably does reduce bowel cancer risk for the person who has it, but a programme that offers colonoscopy achieves much less if most people decline. Programmes based on stool tests with high uptake may deliver as much population benefit at lower cost and risk.
The European counterpart to Siegel 2017, and the evidence a UK screening age extension has to be argued against: the fastest relative rise is in people two decades below any screening programme's start age.
The paper that turned early-onset colorectal cancer from an anecdote into a policy problem, and the direct evidence behind lowering the screening start age from 50 to 45 in the United States.
Durability is what makes endoscopic screening cost-effective: one procedure at 55 buys nearly two decades of protection, which is the argument for long intervals rather than frequent tests.
The first molecular stool test to reach approval, and the template for the blood tests that followed: more sensitive for cancer, much less specific, and still poor at the precancerous lesions that screening is supposed to remove.
The clinical proof of Vogelstein's sequence: interrupting the adenoma-carcinoma pathway with a snare prevents the cancer, which is why colonoscopy is the only screening test that both detects and prevents.
Query for this technology: (TITLE:"Colorectal cancer screening" OR ABSTRACT:"Colorectal cancer screening" OR TITLE:"colonoscopy, FIT, stool DNA, blood" OR ABSTRACT:"colonoscopy, FIT, stool DNA, blood") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood), not a curated reading list.
Shares UK Flexible Sigmoidoscopy Screening Trial, Adenoma detection rate, Screening uptake, Interval cancer.
Shares BLUE-C, DeeP-C, Abbott Laboratories, Cologuard Plus.
Shares Clinical validation of a circulating tumor DNA-based blood test to screen for colorectal cancer (PREEMPT CRC), Abbott Laboratories, PREEMPT CRC, SimpleScreen CRC.
Shares Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial, Long term effects of once-only flexible sigmoidoscopy screening after 17 years of follow-up, Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths (National Polyp Study), Randomised controlled trial of faecal-occult-blood screening for colorectal cancer (Nottingham).
Shares BLUE-C, DeeP-C, PREEMPT CRC, ECLIPSE (Shield blood test).
Shares Katie Couric, Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial, Markey Cancer Center, University of Kentucky, Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years.
Shares Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years, Colorectal cancer incidence patterns in the United States, 1974-2013, Find out what is driving early-onset bowel cancer, starting with colibactin, before extending screening any further, Early-onset colorectal cancer (under 50).
Shares UK gap: match endoscopy capacity and quality to the faecal immunochemical test thresholds the NHS has already set, Shield, Treat screening uptake, not test sensitivity, as the thing to optimise, and settle the age extension with a trial rather than a model, Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers.