RIVM logo, National Institute for Public Healthe and the Enviroment. Minsty of Health, Welfare and Sport

New bowel cancer screening programme

Publication date: 16 January 2014
Modificationdate: 20 October 2016
January 2014 RIVM launches a new bowel cancer screening programme. In the long term, this screening programme can help prevent 2,400 deaths from bowel cancer each year. In the course of 2014, all men and women born in 1938, 1939, 1947, 1949 and 1951 will receive an invitation to participate, followed two weeks later by a self-screening kit.

Bowel cancer is a common, serious disease. In the Netherlands more than 13,000 people a year are diagnosed with the disease. Bowel cancer causes 5,000 deaths every year in The Netherlands. 
Bowel cancer generally develops from polyps in the colon, which themselves do not usually cause any symptoms. Polyps are fairly common in people above the age of 55. Some polyps can develop into malignant tumours, resulting in bowel cancer. Screening enables bowel cancer to be detected at an early stage. At this early stage, the treatment of bowel cancer is often less arduous for patients, and they have a better chance of survival. Screening can also prevent bowel cancer by removing polyps.

Gradual introduction

The screening programme is for all men and women aged 55 to 75 years. Every two years, they will receive an invitation to take a stool test. Screening will be introduced gradually. In 2014, 875,000 people will receive an invitation. The full-scale introduction of screening will take place in 2019. The timing of a person's first invitation is determined by the year in which they were born.
This screening programme is offered by the government. While RIVM coordinates the screening programme as a whole, the actual procedures involved are performed by the same five regional screening organisations that carry out the screening programmes for breast cancer and cervical cancer.

Stool test

Starting on 13 January, the first group will receive letters containing announcements of the upcoming bowel cancer screening programme. Two weeks later, they will receive a purple envelope containing the stool test, instructions, and an information leaflet. The stool test requires participants to take samples at four different points in their stool. The test kit is sent to a laboratory for analysis in which the sample is tested for the presence of blood. It takes two weeks before the results are known. For every 1,000 people who participate in the screening programme, 950 do not need further examination.

Colonoscopy

If blood is found in the stool sample, the patient will be invited to undergo colonoscopy (an internal examination) at a colonoscopy centre. Internal examination often uncovers the reason for the presence of blood in stool samples. While this may be due to bowel cancer, there are a number of other possible causes. The colonoscopy is preceded by an intake interview at the colonoscopy centre. If 50 people in every 1,000 screened undergo colonoscopy, then four of these individuals will be diagnosed with bowel cancer. Twenty-one will have advanced-stage polyps and a further 12 will be found to have early-stage polyps. Thirteen people will neither have cancer nor any polyps.

Participation in the screening programme is entirely voluntary. There is no charge for the stool test. The costs of any further examination, of the intake interview, and of the colonoscopy will be reimbursed by the participant’s health insurance company. Depending on the size of their health insurance excess, some participants may have to meet part of the cost of the further examination themselves.

Further details (in Dutch) at: http://www.bevolkingsonderzoekdarmkanker.nl/.

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