Remote Follow-Up After Colorectal Cancer Surgery: A Systematic Review

Remote consultations are increasingly being utilized in colorectal cancer follow-up, especially since the COVID-19 pandemic, with benefits continuing beyond the pandemic. It is not clear how remote modalities affect patient satisfaction, quality of life (QoL) and safety of colorectal cancer follow-up.

To investigate the impact of remote follow-up on patient satisfaction, QoL, clinician satisfaction, adherence to investigations, readmission rates, recurrence rates, and mortality rates for colorectal cancer.

A systematic review was performed using three electronic databases: MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials, along with grey literature. Eligible studies included remote techniques such as telephone, video, or patient-initiated follow-up (PIFU) compared with standard face-to-face follow-up in patients who have undergone colorectal cancer resection. Two independent reviewers screened studies and assessed the risk of bias.

A total of 4417 records were identified with seven studies included. Six studies showed high levels of patient satisfaction in remote follow-up, with two studies showing significantly better satisfaction than standard follow-up. Two studies evaluated QoL, with one showing significantly better QoL in the remote follow-up group than the standard, and the other study showing comparable levels. Safety outcomes were minimally reported, but there were no adverse outcomes. There was at least moderate risk of bias in the four nonrandomized interventions due to confounding from patient selection into intervention groups.

Remote follow-up in colorectal cancer appears to be comparable to face-to-face follow-up with high levels of patient satisfaction and QoL. While adherence to follow-up investigations was not compromised, the evidence on oncological impact is limited, and further studies on mortality and recurrence rates are required to ensure overall safety.