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CT colonography is more effective than barium enema and better tolerated. [720] The 2018 American Cancer Society (ACS) Colorectal Cancer Screening for Average-Risk Adults Guideline Update also reads, double-contrast barium enema is no longer included as an acceptable screening option. [721] During the CY 2023 PFS, we received a joint public comment from the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA) and the American Society for Gastrointestinal Endoscopy (ASGE) [722] that brought to our attention that barium enema is not a recommended CRC screening modality in guidance from the USPSTF or the U.S