Screening policies for colorectal cancer are costly, as they are to be applied to a large potential population. Cost-effectiveness analysis of potential screening policies is therefore warranted and depends on local circumstances and healthcare systems. Most studies have used modeling approaches, with a few exceptions on the use of fecal occult blood tests. Current conclusions of economic studies tend to favor either double barium contrast enema or sigmoidoscopy as a mass screening tool, although colonoscopy might prove cost-effective in some circumstances. Further research is needed to assess the cost-benefit of mixed strategies in large populations.