Objective To investigate the clinical value of fecal microRNA-296-3p (miR-296-3p) combined with carcinoembryonic antigen (CEA) in the screening of colorectal cancer.Methods A total of 104 patients diagnosed with colorectal cancer by pathological examination and admitted to the Affiliated Hospital of Chengde Medical College from June 2021 to February 2023 were selected as the colorectal cancer group. Additionally, 61 healthy individuals who underwent physical examinations at the same period in the hospital were selected as the healthy control group. Clinical data between the two groups were compared. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression of miR-296-3p in feces of both groups. Multivariate stepwise logistic regression analysis was performed to identify independent risk factors for colorectal cancer occurrence. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of miR-296-3p, CEA alone, and their combination for colorectal cancer.Results RT-PCR results showed that the relative expression level of miR-296-3p mRNA in feces was lower in the colorectal cancer group compared to the healthy control group (P < 0.05). Univariate analysis revealed significant differences in the expression levels of miR-296-3p and CEA between the colorectal cancer and healthy control groups (P < 0.05). Multivariate stepwise logistic regression analysis demonstrated that the expression of miR-296-3p [O^R =0.70 (95% CI: 0.55, 0.90)] and CEA [O^R =1.78 (95% CI: 1.32, 2.40)] were independent risk factors for colorectal cancer occurrence (P < 0.05). The individual prediction probability equation was P =1/e^{-(-0.399-0.351X}₁^+0.577X₂⁾. The sensitivity and specificity of the miR-296-3p prediction model for diagnosing colorectal cancer were 79.8% and 42.6%, respectively, with an AUC of 0.687. The sensitivity and specificity of the CEA prediction model for diagnosing colorectal cancer were 81.4% and 59.6%, respectively, with an AUC of 0.800. The sensitivity and specificity of the miR-296-3p combined with CEA prediction model for diagnosing colorectal cancer were 86.3% and 63.5%, respectively, with an AUC of 0.847.Conclusion The predictive model combining miR-296-3p and CEA has good predictive value for colorectal cancer.