Colorectal cancer screening of average-risk adults has at last been shown to be a cost-effective prevention strategy. Although universally performed, postoperative diagnostic screening in colorectal cancer patients has not been demonstrated to diminish overall mortality. Such screening often leads to second look surgery, with many anecdotal successes but again no evidence that overall mortality is reduced. The cost of such interventions is at least $1 billion per year in the United States and could be double that. The research needed to support postoperative screening and surgery is feasible and economically easily justified. The endpoints must just be shifted from that of previous studies, which have focused on sensitivity of screening techniques, to mortality.