ABSTRACT:
Colorectal cancer (CRC) survivors require follow-up for up to five years post-treatment, yet traditional models are often fragmented, resource-intensive, and difficult to sustain. Patients may be lost to follow-up, while clinicians spend substantial time coordinating care across disconnected systems. A digital platform combining a patient-facing app with a web-based clinician dashboard has been prototyped in collaboration with a colorectal surgeon to improve efficiency, continuity, and data capture. This study explored current follow-up practices and stakeholder needs to determine how digital technology could support CRC survivorship care. We conducted an exploratory, stakeholder-informed qualitative study using a pragmatic inquiry approach to understand the current landscape of CRC follow-up. Semi-structured interviews and workshops were held with clinicians, health service staff, and system stakeholders, including advocacy and cancer registry representatives. Participants reviewed a prototype designed to digitise follow-up processes. Data collection and analysis were inductive, allowing participant priorities and experiences to guide the findings. Discussions focused on care coordination, use of patient-reported outcome measures (PROMs), data availability, survivorship support needs, and implementation considerations. The prototype was well received by health staff (n=17) and stakeholders (n=5). Follow-up practices varied across services, with sensitive issues such as sexual function under-addressed and PROMs used inconsistently. The transition from treatment to survivorship was described as a challenging adjustment period, likened by some to returning to “civilian life after war.” Survivors were perceived to have ongoing physical, psychosocial, and informational needs once structured treatment ends. Gaps in survivorship data limited the ability to assess whether follow-up schedules are optimally tailored to cancer type and surgical pathway, highlighting the need for improved data capture to support risk-stratified care. As cancer survivorship populations grow worldwide, these findings offer practical guidance for designing scalable, patient-centred, digitally supported follow-up models that improve care continuity, data quality, and links between clinical and community services.