Background: Colorectal cancer (CRC) survival is improving, yet long-term survivors remain at risk for cancer- and treatment-related late effects, of which some may emerge many years after diagnosis and after cancer treatment has been completed. 

Objectives:We aimed to summarize the late effects and their risk factors reported at least five years after CRC diagnosis, in comparison with cancer-free controls.

Methods: The literature search for this scoping review was conducted in PubMed, EMBASE and Web of Science from inception to November 18, 2025. Primary research studies investigating late effects and providing relative risks estimates specifically ≥5 years after diagnosis in adult CRC survivors were included. The Newcastle-Ottawa Scale was used to assess the risk of bias. The study was registered with the Open Science Framework, 10.17605/OSF.IO/JY6DX

Results: We identified nine observational studies that reported relative risks estimates for late effects. A low risk of bias was assigned to six studies and three were at moderate risk. The most frequently investigated late effect was incidence of diabetes (five studies). The highest relative risk were reported for immunity disorder (5-10 years hazard ratio (HR) 4.56, 99% CI [1.36 -15.31]), depression (>5 years HR 2.65, 95%CI[1.61-4.36]) and nutritional deficiency (5-10 years HR 1.69, 99% CI [1.38 - 2.08). Comorbidities at diagnosis, age at diagnosis and cancer treatment were the most common risk factors found to be associated with the occurrence of late effects.

Conclusions/Implications for practice or policy: This scoping review found that even 5 years after CRC diagnosis specific late effects requiring treatment are considerably more common than among cancer-free controls. The small number of studies and the broad spectrum of identified late effects highlight the need for more extensive research to characterize late effects of CRC and their risk factors to improve long-term survivorship care in the future.