A cement board screw a high thread that begins on the tapered end, extends onto the shank and terminates at a second axial location along the shank. The high thread defines a high peripheral edge, where a leading flank and a trailing flank meet at the high peripheral edge and together define a high thread angle that is between about thirty degrees and about fifty-five degrees. A low thread begins on the tapered end, extends onto the shank and terminates substantially at a first axial location along the shank such that an axial length of the low thread is less than an axial length of the high thread. The low thread includes a leading flank and a trailing flank that meet at a low peripheral edge and together define a low thread angle that is between about fifty degrees and about seventy degrees.