Crosby RA, et al. - The innovation of fecal immunochemical testing (FIT) for identification of polyps in the rectum and colon for removal by colonoscopy has led researchers to determine the cost per life-year gained (LYG) when using FIT as a population-level screening model among rural Appalachians experiencing isolation and economic challenges. They conducted this study in an 8-county area of southeastern Kentucky distributing kits to 1,424 residents. Of these, 732 kits (51.4%) were completed and returned. For this population of medically underserved rural residents, a highly favorable cost-effectiveness ratio was recorded in contrast to an average cost per LYG of $17,200. As per cost-benefit analyses, positive net benefits of the screening program begin at the stage when project recipients undergo colonoscopy, indicating that this is the key step for behavioral intervention and intensified outreach.