5 surprising tests that could change how you screen young adults for CRC

By MDLinx staff

Published April 17, 2025

Key Takeaways

Industry Buzz

“Having a simple blood test for colorectal cancer that could be added to a routine medical visit is a major step toward closing the screening gap.” — Asad Umar, DVM, PhD
“No adult is ‘too young’ to have cancer. I routinely see patients in their 30s to 40s with symptoms for months, and workup is delayed.” — Laura Vater, MD, MPH

Find more of your peers' perspectives and insights below.

Colorectal cancer (CRC) isn’t just a disease for older adults anymore—it's affecting younger populations at an alarming rate. As the landscape of CRC shifts, it’s more important than ever for physicians to evolve their screening strategies.

Are you staying ahead of the curve? These five underutilized screening methods might be just what your practice needs to catch CRC early and fight back against this growing crisis in younger adults.

Shield blood test

The Shield blood test, FDA-approved in 2024, is a non-invasive tool for colorectal cancer (CRC) screening. It analyzes cell-free DNA to detect CRC in average-risk adults aged 45 and older. With its potential to increase patient compliance, especially among those hesitant about traditional screenings, Shield is gaining attention as a game-changer.

While it’s not as sensitive for early-stage cancers, clinical trials showed 83% sensitivity for detecting CRC overall, with high specificity for advanced neoplasia.^[] This makes it an effective first-line screening tool, especially for younger patients who may avoid colonoscopy.

Although positive results require confirmation via colonoscopy, Shield’s real value lies in improving patient participation in CRC screening. By offering a non-invasive, accessible option, it could help bridge the gap in early detection, ultimately reducing the burden of late-stage CRC.

Fecal immunochemical tests (FIT)

FIT is a simple, non-invasive test that detects blood in stool, commonly used for older adults. But here’s the catch—doctors should start using FIT for younger patients at higher risk for colorectal cancer.^[]

While colonoscopy is the go-to for routine screening, FIT could serve as a first-line option for younger adults who aren’t yet due for regular screenings but are at increased risk. It’s an effective tool that can detect early signs of CRC in those who may not yet meet traditional screening criteria.^[]

The benefits? No dietary restrictions and easy patient compliance. For many younger patients, FIT offers a way to catch potential issues without the invasive nature of a colonoscopy.

It’s time we rethink how FIT can be integrated into the screening strategy for younger adults—especially for those who may otherwise avoid traditional methods.

Genetic testing

Genetic testing for mutations like Lynch syndrome and familial adenomatous polyposis (FAP) can help identify patients at high risk for colorectal cancer, even without a strong family history. Tests like the Lynch syndrome panel (looking for mutations in genes such as MLH1, MSH2, and MSH6) and FAP testing (which checks for APC gene mutations) can pinpoint individuals at increased risk. ^[]

Offering these tests enables earlier, more frequent screenings, helping high-risk patients begin screening well before age 50. This proactive approach is key to managing CRC risk in younger adults and catching potential issues early.

CT colonography (virtual colonoscopy)

CT colonography, or virtual colonoscopy, is a non-invasive alternative that uses CT scans to create detailed images of the colon. While not as common as a traditional colonoscopy, it’s a great option for younger adults who may be uncomfortable with a full colonoscopy. Virtual colonoscopy offers a less invasive approach while still effectively detecting polyps and tumors.

Blood biomarker testing for CRC

Blood-based biomarker tests for CRC are showing great promise for early detection—possibly even before symptoms arise. Though still under development, these tests could provide a simple, non-invasive screening option. For younger patients hesitant about colonoscopy or FIT, blood biomarker testing could offer a viable future solution. Staying on top of these advancements ensures you're ready to implement this emerging tool in your practice as it becomes available.

Bottom line

As colorectal cancer continues to rise in younger populations, it’s crucial for physicians to rethink their screening strategies. By integrating these five methods into your practice, you can catch CRC early, improve patient compliance, and ensure that younger adults aren’t overlooked in the push for early detection.