Orsak, GabrielaMiller, AnastasiaAllen, Carlton M.Sing, Karan P.McGaha, Paul2019-10-072019-10-072019This is the published version of an article that is available at https://doi.org/10.1007/s41669-019-0147-y. Recommended citation: Orsak, G., Miller, A., Allen, C. M., Singh, K. P., & McGaha, P. (2019). Return on investment of free colorectal cancer screening tests in a primarily rural uninsured or underinsured population in Northeast Texas. PharmacoEconomics - Open, 4(1), 71–77. This item has been deposited in accordance with publisher copyright and licensing terms and with the author’s permission.https://doi.org/10.1007/s41669-019-0147-yhttps://hdl.handle.net/11274/11864Article originally published in PharmacoEconomics - Open, 4(1), 71–77. English. Published Online 2019. https://doi.org/10.1007/s41669-019-0147-yBACKGROUND: Colorectal cancer (CRC) is the third most common cancer in the USA. Its economic impact is extensive, and preventive screening services are warranted to help prevent it.OBJECTIVE: We sought to examine the return on investment, in terms of reduced costs attributed to cancer prevention, of a CRC screening outreach program providing education and screening in a primarily rural region targeting the uninsured and underinsured.METHODS: The expenditures of the Northeast Texas CRC screening program were calculated for the years of 2016 and 2017. Prices ($US) were adjusted for inflation and converted to year 2017 values. The costs saved were calculated using the estimated costs of CRC care present in the literature.RESULTS: For fiscal years 2016 and 2017, the program provided an average return of $US1.46–2.06 for every tax dollar spent. Estimated cost avoidance was $US165,080 per avoided case and estimated cost avoidance of $US245,601 among early-stage cancer cases detected, resulting in potential savings ranging from $US3,893,676 to $US4,837,923.CONCLUSION: A CRC outreach program providing education and screening operating in less densely populated regions yields a positive return on investment.en-USFecal Immunochemical Testing (FIT)Adenomatous polypsMultiple screening methodsArticleCC-BY-NC