Journal article
The Centers for Medicare and Medicaid Services and others misunderstand stool testing for colorectal cancer
JNCI : Journal of the National Cancer Institute, Vol.118(3), pp.386-391
03/2026
DOI: 10.1093/jnci/djaf341
PMCID: PMC13017659
PMID: 41324575
Abstract
The May 2021 Centers for Medicare and Medicaid Services (CMS) coverage determination allowed reimbursement for blood-based biomarker tests and other tests for colorectal cancer (CRC) screening that meet minimum 74% sensitivity and 90% specificity thresholds. However, these performance benchmarks fail to account for the importance of detecting precancerous lesions and the impact of the recommended testing interval on the effectiveness of screening. We review the limitations of the CMS criteria, summarize supporting evidence for stool-based testing and colonoscopy as effective and cost-efficient screening modalities, and offer recommendations to strengthen CMS coverage decisions to better align with public health goals in CRC prevention.
Details
- Title: Subtitle
- The Centers for Medicare and Medicaid Services and others misunderstand stool testing for colorectal cancer
- Creators
- Gloria D Coronado - University of ArizonaRichard M Hoffman - University of IowaJosheili Llavona-Ortiz - University of ArizonaCarolyn M Rutter - Fred Hutch Cancer Center
- Resource Type
- Journal article
- Publication Details
- JNCI : Journal of the National Cancer Institute, Vol.118(3), pp.386-391
- DOI
- 10.1093/jnci/djaf341
- PMID
- 41324575
- PMCID
- PMC13017659
- NLM abbreviation
- J Natl Cancer Inst
- ISSN
- 1460-2105
- eISSN
- 1460-2105
- Publisher
- Oxford University Press; CARY
- Grant note
- National Institute of Minority Health and Health Disparities: 1R01MD 018253-01 National Cancer Institute: NCI R01 CA265020-01, NCI T32 CA272303 02 National Institutes of Health
This publication was supported by the National Cancer Institute through award number NCI R01 CA265020-01, NCI T32 CA272303 02, and the National Institute of Minority Health and Health Disparities through award number 1R01MD 018253-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The National Institutes of Health had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.
- Language
- English
- Electronic publication date
- 12/01/2025
- Date published
- 03/2026
- Academic Unit
- General Internal Medicine; Internal Medicine
- Record Identifier
- 9985089133302771
Metrics
8 Record Views