Objective To investigate the efficacy of combination of stool DNA methylation and occult blood test for early screening of colorectal cancer. Methods The study enrolled 89 patients with advanced adenoma ( AA), 270 patients with colorectal cancer (CRC) and 180 healthy controls. Quantitative methylation-specific PCR (qMSP) was used to detect cg13096260 methylation levels in stool samples. Fecal immunochemical testing ( FIT) was employed for occult blood detection. The diagnostic value of cg13096260 combined with FIT for colorectal cancer and advanced adenoma was analyzed. Results Methylation levels of cg13096260 were significantly higher in both AA and CRC groups compared to the control group ( P < 0． 05). There is no significant difference in the methylation levels between the AA group and the CRC group. Positivity of FIT rates was highest in the CRC group, followed by the AA group, and the lowest in the control group. The AUC for cg13096260 alone in detecting AA and CRC reached 0. 8462 and 0. 9144, respectively. After combined with FIT, the AUC of the combined model in the diagnosis of CRC and AA reached a maximum of 0. 9698. Conclusions The methylation level of cg13096260 in feces combined with FIT detection can effectively distinguish patients with AA or CRA from healthy people. Diagnostic performance of combined detection is better than single test. It is expected to provide new options for early screening of colorectal cancer and its precancerous lesions.