Colorectal cancer screening (colonoscopy, FIT, stool DNA, blood)
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.
How it works
Detect adenomas or early cancers by direct visualisation (endoscopy), occult blood or shed DNA in stool, or cfDNA methylation and fragmentation in blood.
- Colonoscopy both detects and prevents by polypectomy
- Non-invasive options raise participation
- Blood and stool tests miss most precancerous polyps
- Colonoscopy capacity and access
- Early-onset cancers arise before screening age
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.
A cheap home stool test, repeated yearly or every two years and followed by colonoscopy when positive, prevents bowel cancer deaths. This is what national bowel screening programmes do today, with FIT replacing the older guaiac test.
Latest papers
topQuery 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.
Pages like this
not linked directly; found by shared links- IdeaPersonalised stool-test cut-offs by age, sex and prior results
Shares Minnesota trial: a yearly stool blood test cuts bowel cancer deaths by a third, NordICC: inviting people to a screening colonoscopy reduced bowel cancer, but less than expected, Most lethal cancers are found late, Colorectal cancer.
- CompanyFreenome
Shares Shield, Multi-cancer early detection (MCED), Most lethal cancers are found late, Liquid biopsy (ctDNA).
- TermAdolescent and young adult (AYA) oncology
Shares Chadwick Boseman, Colorectal Cancer Alliance, Dame Deborah James, Colorectal cancer.
- IdeaMandatory interval-cancer audit for every blood-based screening test
Shares Shield, Multi-cancer early detection (MCED), Most lethal cancers are found late, Liquid biopsy (ctDNA).
- IdeaOffer the blood test for bowel cancer only to people who refuse stool tests or colonoscopy
Shares Shield, Most lethal cancers are found late, Liquid biopsy (ctDNA), Colorectal cancer.
- TermStage shift
Shares Katie Couric, Breath and volatile-organic-compound detection, Kaiser Permanente Division of Research, Multi-cancer early detection (MCED).
- TechnologycfDNA fragmentomics
Shares Paths to cures: interception, eradication, control, Multi-cancer early detection (MCED), Most lethal cancers are found late, Liquid biopsy (ctDNA).
- CompanyGuardant Health
Shares Shield, Multi-cancer early detection (MCED), Most lethal cancers are found late, Liquid biopsy (ctDNA).