OBJECTIVES: Renal cell carcinoma is associated with a stage migration due to earlier diagnosis associated with availability of medical imaging. Surgical treatment remains the preferred treatment option for most patients. Many medical associations have proposed guidelines for the optimal follow up of patients post surgery. The goal of our study was to evaluate the adherence of Canadian urologists to the follow up guidelines proposed by the Canadian Urological Association (CUA) and its economic impact. METHODS: The cohort studied was identified from the Canadian Kidney Cancer information system (CKCis). A total of 1655 patients from 15 academic institutions contributed to this prospectively collected patient population. Patients included in this cohort underwent radical or partial nephrectomy for a pT1-3N0M0 renal cancer after January 1^st