Colon cancer is a common cause of malignancy in men and women. The incidence has been increasing over the past several decades. Fecal occult blood testing has been shown in several randomized controlled studies to reduce the rate of colorectal cancer. The U.S. Preventive Task Force has recommended universal screening after the age of 50. More than 150,000 new cases of colon cancer are diagnosed each year. The mortality rate continues to be greater than 50% in these diagnosed cases. Various fecal occult blood tests (FOBT) used in screening colorectal cancer have reduced mortality by 15-30%. OBJECTIVE: The purpose of this study was to assess the effectiveness of fecal occult blood testing (FOBT) in reducing the mortality rate from colorectal cancer as past of a managed-care program. The suggested number of patients needed for screening to prevent one death from colon cancer is 1374 for 5 years. The cost of FOBT is relatively inexpensive as compared to colonoscopy or barium enema, which may cost more than $1000.00. A guaiac-based test was utilized costing approximately $0.81 per test. METHOD: Patients in primary care were included in routine preventive screening to include FOBTs. We evaluated 2021 FOBTs during FY1997. RESULTS: $1637.01 was spent screening 2021 patients. Four asymptomatic patients were detected to have colon cancer as a result of this screening. One potential death was prevented for every 505.25 patients screened. CONCLUSION: In certain managed-care patient populations, this may be an even more cost-effective approach in colorectal screening.