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Objectives. This study examined the cost-effectiveness of general and targeted strategies for residential radon testing and mitigation in the United States. Methods. A decision-tree model was used to perform a cost-effectiveness analysis of preventing radon-associated deaths from lung cancer. Results. For a radon threshold of 4 pCi/L, the estimated costs to prevent 1 lung cancer death are about $3 million (154 lung cancer deaths prevented), or $480 000 per life-year saved, based on universal radon screening and mitigation, and about $2 million (104 lung cancer deaths prevented), or $330 000 per life-year saved, if testing and mitigation are confined to geographic areas at high risk for radon exposure. For mitigation undertaken after a single screening test and after a second confirmatory test, the estimated costs are about $920000 and $520000, respectively, to prevent a lung cancer death with universal screening and $130000 and $80000 per life-year for high risk screening. The numbers of preventable lung cancer deaths are 811 and 527 for universal and targeted approaches, respectively. Conclusions. These data suggest possible alternatives to current recommendations. [ABSTRACT FROM AUTHOR]