The MedicalXpress report highlights the American Cancer Society's May 2026 guideline expansion adding multitarget stool DNA tests every three years and blood-based assays for average-risk adults starting at age 45, yet it underplays critical performance trade-offs documented in peer-reviewed trials. An RCT of the Shield circulating tumor DNA blood test (n=7,861, NEJM 2024) reported 83% sensitivity for colorectal cancer but only 90% specificity, generating excess false positives that could strain colonoscopy capacity without proven mortality benefit; this observational follow-up phase remains ongoing. In contrast, the 2014-2019 DeeP-C RCT (n=9,989) for Cologuard stool testing achieved 92% sensitivity and reduced advanced neoplasia detection gaps versus FIT alone, though both require diagnostic colonoscopy after positives. The original coverage overlooks how these additions may widen disparities: lower-sensitivity blood tests were positioned as fallback options precisely because they underperform for polyp detection, echoing patterns seen in the 2016 USPSTF evidence review where stool tests showed stronger preventive impact in high-uptake populations. Conflicts of interest in blood-test manufacturers' funding of early studies further warrant caution until independent meta-analyses confirm equivalence. Ultimately, while choice improves adherence, colonoscopy retains superiority for symptomatic or high-risk cases per current observational cohort data.