Screening of average risk individuals can reduce colorectal cancer mortality by detecting cancer at an early curable stage, and by detecting and removing advanced neoplasia. No screening test is perfect – either for cancer detection or polyp detection. Each test has advantages, limitations and risks. Patient preferences and availability of resources play an important role in the selection of screening tests. This update of the guidelines for colorectal cancer screening have placed an emphasis on the value of preventing colorectal cancer, sought to address the importance of test sensitivity in the presence of low rates of programmatic screening, and attempted to provide improved guidance about test characteristics to referring clinicians. It is our hope that these new recommendations facilitate increased rates of colorectal cancer screening, and that referring clinicians find these new guidelines ease some of the challenges they have experienced in promoting colorectal cancer screening to their patients.