Advances in colorectal cancer screening: technological innovations, guideline discrepancies, and individualized strategies.

Colorectal cancer (CRC) is the second leading cause of cancer-related mortality worldwide. Numerous clinical and epidemiological studies have demonstrated that early screening can significantly reduce both the incidence and mortality of CRC. This review systematically summarizes recent advances in CRC screening technologies. It first reviews the current applications of traditional screening tools such as colonoscopy and fecal occult blood tests, then focuses on emerging molecular detection techniques based on DNA, RNA, proteins, and metabolites, as well as representative multi-omics integration approaches. Furthermore, it discusses the innovative use of artificial intelligence (AI) and image recognition technologies in CRC screening. At the guideline level, we compare recent updates and implementation differences among major national screening guidelines, including those of the U.S. Preventive Services Task Force (USPSTF), and analyze key challenges in current screening practices. Finally, we propose directions for future development. By integrating existing evidence, this review aims to provide clinical reference for transforming CRC screening from population-based to precision-based individualized prevention, promoting its wide, efficient, and sustainable implementation.