Physicians have a plethora of options when choosing a diagnostic test or procedure for colon cancer screening. Clinicians are no longer limited to fecal-occult blood tests and standard colonoscopy. Newer choices include advanced stool tests and imaging modalities like computed tomography colonography. Even the "standard" colonoscope has multiple accessories, ranging from simple plastic caps to multi system high-definition imaging. Each new innovation brings with it data touting its excellence, and deciding the best modality can be a daunting task. As more information is learned about the natural history of precancerous polyps and colorectal cancer, screening guidelines have become more complex. This article reviews current screening modalities and new adjuncts to currently used techniques. (C) 2016 Published by Elsevier Inc.