Question: 2016 PQRS- CMS130- Colorectal Cancer Screening:
Is Fecal DNA an acceptable screening method for colorectal cancer screening?

There is conflicting information on CMS webpage regarding approved screening methods for colorectal cancer screening. See attachments

• There was a web interface Q&A session support call on January 16, 2017 and the power point states:
  Yes, based on the updated USPSTF guidelines (June 2016), the 2016 PREV-6: Colorectal Cancer Screening measure will allow for FIT-DNA screening such as Cologuard as well as Computed tomography (CT) colonography to be considered numerator compliant when reporting via the 2016 GPRO Web Interface. Documented performance of Fecal Immunochemical DNA Testing during the measurement period or two years prior to the measurement period will be numerator compliant.

• The eCQM CMS130v4 states the following:
  *[2] The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic (CT) colonography and fecal DNA testing as screening modalities for colorectal cancer (I statement).

The American Cancer Society, The American College of Radiology, and the U.S. Multi-Society Task Force on Colorectal Cancer (Levin et al. 2008):

Tests that Detect Adenomatous Polyps and Cancer
[1] Colonoscopy (every 10 years)
[2] Flexible sigmoidoscopy (every 5 years)
[3] Double contrast barium enema (DCBE) (every 5 years)
[4] Computed tomographic colonography (CTC) (every 5 years)

Tests that Primarily Detect Cancer:
[1] Guaiac fecal occult blood test (gFOBT) with high sensitivity for cancer (annually)
[2] Fecal immunochemical test (FIT) with high sensitivity for cancer (annually)
[3] *Stool DNA (sDNA) with high sensitivity for cancer (interval uncertain)

Modalities not approved:
[2] Studies evaluating virtual colonoscopy and fecal DNA testing for CRC screening have yielded conflicting results and therefore cannot be recommended

The numerator does not list Fecal DNA.

Can you please confirm if Fecal DNA is an acceptable method to screen for colorectal cancer screening? Thank you!