Patient-led home-based follow-up reduces hospital contacts by 38% in colorectal cancer survivorsPatient Led Follow Up Reduces Hospital Visits for Cancer Survivors

The British journal of surgery Published August 11, 2026 Study authors: van Driel M H Elise, Swartjes Hidde, Lemmens Jobbe M G, Qaderi Seyed M, Teerenstra Steven, Custers J… PubMed ↗ DOI ↗ Editorial oversight: Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

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Key Takeaway

Note that PHFU may reduce hospital contacts in CRC survivors, though results were only significant in as-treated analysis.

This cluster randomized trial enrolled 354 survivors of stage I-III colorectal cancer who were disease-free at 12 months post-surgery across six Dutch hospitals. The study compared patient-led, home-based follow-up (PHFU) against standard hospital-based follow-up.

In the primary outcome of hospital contacts, an intention-to-treat analysis showed no significant difference between groups. However, an as-treated analysis revealed that PHFU reduced hospital contacts by 38% compared with standard follow-up (rate ratio 0.62; 95% c.i. 0.51 to 0.75, P < 0.001). Secondary outcomes, including quality of life (EORTC QLQ-C30), cancer-related worry, and psychological distress, showed no significant differences between the intervention and control groups.

A major limitation was substantial crossover: 117 patients assigned to PHFU received standard follow-up, while 10 patients assigned to standard follow-up received PHFU. Safety data and tolerability were not reported. While as-treated results suggest a reduction in hospital contacts, the lack of significance in the intention-to-treat analysis limits certain conclusions regarding the impact of crossover on outcomes.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in management strategies for colorectal cancer survivors following surgical intervention. While previous coverage noted that ultra-processed food intake correlates with 12% higher risk of digestive system cancer and AXIN2 mutations link to colorectal polyposis, this study focuses on the post-surgical follow-up phase. It provides evidence regarding the feasibility of home-based models for managing survivors who have achieved a disease-free status at 12 months.

Researchers conducted a study in the Netherlands involving 354 survivors of stage I to III colorectal cancer. These patients were at least one year clear of disease after their surgery. The study compared a patient led, home based follow up program against the standard hospital based follow up method.

A specific analysis showed that those who participated in the home based program had 38% fewer hospital contacts than those receiving standard care. However, other measures such as quality of life and psychological well being did not show significant differences between the two groups.

It is important to note that these results were only clear when looking at patients who strictly followed their assigned program. Because many patients switched between the two types of follow up during the study, the overall results were less certain. This finding suggests that home based programs are a feasible alternative for survivors, but more research may be needed to confirm long term benefits.

What this means for you:

Home based follow up may reduce hospital visits for colorectal cancer survivors, though it did not change quality of life.

Common questions

How does this follow up differ from standard care?

Standard follow up usually involves regular contact with the hospital. The alternative studied was a patient led, home based follow up (PHFU). This program is designed to be an effective and feasible way for colorectal cancer survivors to manage their follow up outside of a traditional hospital setting.

Did the home based program improve quality of life?

The study found no significant differences in quality of life, psychological distress, or cancer related worry between those who used the home based program and those who received standard follow up. Both groups reported similar levels of well being during the study period.

Was the reduction in hospital visits proven for everyone?

The 38% reduction in hospital contacts was only significant when looking at patients who stayed in their assigned group. Because many patients switched between the two types of follow up, the overall results were less clear. You should talk to your doctor about which follow up method is best for you.

Study Details

Study typeRct

Sample sizen = 117

EvidenceLevel 2

PublishedAug 2026

PMID42359543

View Original Abstract ↓

BACKGROUND: Colorectal cancer (CRC) incidence is rising; consequently, traditional follow-up care models are increasingly unsustainable. Patient-led, home-based follow-up (PHFU) may offer a promising alternative to reduce hospital visits while maintaining patient well-being. METHODS: The DISTANCE trial was a stepped-wedge cluster randomised trial conducted in six hospitals in the Netherlands. A total of 354 stage I-III CRC survivors, disease-free at 12 months after surgery, were assigned to either PHFU or standard follow-up. The primary endpoint was the number of hospital contacts. Secondary endpoints included quality of life (assessed using the European Organisation for Research and Treatment of Cancer core quality-of-life questionnaire (EORTC QLQ-C30); version 3.0), cancer-related worry (assessed using the Cancer Worry Scale (CWS)), and psychological distress (assessed using the Hospital Anxiety and Depression Scale (HADS)). RESULTS: In the intention-to-treat (ITT) analysis, no significant difference in hospital contacts was observed. In the as-treated (AT) analysis, PHFU reduced hospital contacts by 38% compared with standard follow-up (rate ratio 0.62 (95% c.i. 0.51 to 0.75), P < 0.001). There was substantial crossover, with 117 patients assigned to PHFU receiving standard follow-up and 10 patients assigned to standard follow-up receiving PHFU. No significant differences between the two groups were found with regard to quality of life or psychological well-being. CONCLUSION: The DISTANCE trial suggests that PHFU is a feasible and effective alternative to standard hospital-based follow-up for CRC survivors.

Patient-led home-based follow-up reduces hospital contacts by 38% in colorectal cancer survivorsPatient Led Follow Up Reduces Hospital Visits for Cancer Survivors

How this fits prior evidence

Common questions

Study Details

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Patient-led home-based follow-up reduces hospital contacts by 38% in colorectal cancer survivorsPatient Led Follow Up Reduces Hospital Visits for Cancer Survivors

How this fits prior evidence

Common questions

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