Colon cancer is an important gastrointestinal cancer that has increasing prevalence in the present day.Screening for colon cancer is accepted as a method for colon cancer prevention. There are many methods forscreening for colon cancer. However, the best method is colonoscopy. Nevertheless, the simple classical methodas occult blood test is still widely used in clinical practice. Here, the author appraises on colonoscopy with andwithout occult blood test pre-screening. The aim is to compare the cost effectiveness and cost utility betweenthese two approaches. Based on the present appraisal, the colonoscopy without pre-screening occult blood testprovides more cost effectiveness than colonoscopy with such pre-screening.