Objective: To assess the cost, effectiveness and cost-effectiveness of three colorectal cancer (CRC) screening strategies. Methods: Simulation modeling was used to assess three colorectal screening strategies of a virtual population over 50 years old: computed tomographic colonography (CTC), colonoscopy and Fecal occult blood tests (FOBT). The model used a simulation decision framework over a ten-years period. CTC is repeated after 10 years if negative, and after three or five years if positive with advanced or non-advanced adenoma respectively. Colonoscopy is repeated after ten years if negative and after three years or five years if positive with advanced or non advanced adenoma respectively. FOBT is repeated every two years. Positive CTC and FOBT are systematically confirmed by colonoscopy.The model computes the total cost and the incidence of CRC after ten years of each screening strategy. Results: Considering a population adherence of 50%: colonoscopy being the only screening strategy over 10 years is the most costly screening strategy, €885 per individual, with 0.54% of remaining CRC. CTC as only screening strategy over 10 years costs €543 per individual with 0.18% of remaining CRC. FOBT as only screening strategy over 10 years costs €459 per individual with 0.18% of remaining CRC. Mean cost-effectiveness ratios expressed as cost-per-CRC-avoided are 544 with CTC, 890 with colonoscopy and €460 with FOBT. Conclusion: This simulation modeling approach allows to take into account data variability and to test various screening strategies. Further simulations have been performed to study the impact of various screening program adherence various. This original approach could be useful to perform budget impact studies before implementing large public health screening programs.