Follow-up colonoscopy after abnormal stool-based colorectal cancer screening: a systematic review of completion, timeliness and implementation strategies

To synthesise evidence on diagnostic colonoscopy completion and time-to-colonoscopy after abnormal stool-based colorectal cancer screening tests and to examine the implementation strategies and health-system configurations used to support follow-up.

Systematic review with narrative synthesis, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement and the Synthesis Without Meta-analysis reporting guideline.

We searched MEDLINE via PubMed, Embase via Ovid and Scopus for articles published from 1 January 2010 to 28 October 2025. Reference lists of included studies were also screened.

Randomised and non-randomised trials, observational studies, mixed-methods studies and eligible programme evaluations involving adults with an abnormal faecal immunochemical test, guaiac faecal occult blood test or multitarget stool DNA-faecal immunochemical test were included. Eligible studies reported diagnostic colonoscopy completion, time to colonoscopy or implementation-related outcomes.