Trial reportThe British journal of surgery2026
Patient-led, home-based follow-up for colorectal cancer: DISTANCE multicentre stepped-wedge cluster randomised trial.
Trial report in The British journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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18 authors.
Funding
Abstract
backgroundColorectal 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.
methodsThe 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)).
resultsIn 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.
conclusionThe DISTANCE trial suggests that PHFU is a feasible and effective alternative to standard hospital-based follow-up for CRC survivors.
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