Population screening must be equal and accessible to all. That was not the case. People in some regions had to wait (much) longer for breast screening tests than in other regions, and there was also a lot of difference in waiting times within regions.

To maintain national accessibility and equivalent access for all participants, it was necessary to extend the period between screening tests to a maximum of 3 years. The effects of this are now noticeable. The biggest outliers have been eliminated. The average time between 2 invitations is now 29 months. This is substantially less than the maximum 36 months that the State Secretary allowed.

This also allowed more room to invest in screening staff, especially in the training (in Dutch) of people. This is necessary to eventually have more staff and return to a shorter interval between screening tests.

This adjustment started in early 2021. So people are still being invited, but there is some delay. How long this situation will last is currently unknown.

This has to do with the shortage of screening staff for the population screening.

That depends on the region where you live.

Nationally, the average time between 2 invitations is now 29 months. Due to regional and local differences, this may be shorter or longer for you.

The average of 29 months as the time between two screening tests applies to each age group. In this way, the National Programme for Breast Cancer Screening is accessible and equivalent across the country.

Every year, around 1.3 million women in the Netherlands usually receive an invitation for the National Programme for Breast Cancer Screening. Of those invited, about 1 million women participate in the screening test. With the extension of the period between screening tests, fewer women are invited each year. The balance between the number of women invited and the number of women that can be screened has therefore improved.

In principle, the adjustment is a temporary measure, but it will continue for a number of years. The cause of the delay – the shortage of staff – will not be resolved in the short term. Everyone involved is working hard to invite people back every 2 years as soon as possible.

The aim of population screening is to detect breast cancer early so that treatment is more likely to succeed or the treatment is less severe. For some, screening later can be beneficial if an abnormality that was not previously visible is found. However, a longer period of time between screening tests in some cases also leads to the delayed detection of breast cancer and to fewer deaths being prevented.
 

A mammogram, ultrasound or MRI can  only be performed after referral by the GP based on symptoms or changes in the breast(s) or referral from the National Programme for Breast Cancer Screening. The hospital will then determine what type of examination is required. These examinations are outside the scope of the population screening and are covered by the Health Insurance Act. Your health insurance excess may apply. If you notice any symptoms or changes to your breast, please contact your GP and do not wait for an invitation from the National Programme for Breast Cancer Screening.

A longer period between two screening tests will reduce the health benefits of population screening. In the coming years, up to 2039, breast screening tests every 2 years would prevent about 1450 deaths every year. A period of 3 years between screening tests would mean about 60 fewer preventable deaths per year in that period until 2039, according to calculations. Later, with new, more favourable forecasts, this expectation was revised to around 30 fewer avoided deaths per year. In July 2023, it was announced that the aim of returning to invitations again every 2 years for the next round at the beginning of 2024 would not be met. As a result, the number of deaths prevented each year is expected to be 30 to 60 fewer.

The implementing organisations have been taking action for some time to retain sufficient screening operators and to recruit and train new staff. This includes, for example, setting up additional training and recruitment campaigns to attract new employees (in Dutch). Extension of the interval period is also necessary to make room for training new screening operators.

If you are concerned, please contact your GP. Your GP may discuss with you whether there is (a suspicion of) familial or hereditary breast cancer.

If you have any symptoms, or see or feel any of these changes, ask your GP for advice. Your GP may refer you to the hospital for further examination. If you have symptoms, do not wait for the invitation to the population screening and do not make an appointment at the screening centre. The breast cancer screening is intended for people without symptoms.

We will publish a news article on the website and post about it on the social media channels of RIVM and the Centre for Population Screening.

Please allow an average of 29 months after your previous invitation. This may also be earlier or later, depending on your region. This is further explained in this Parliamentary Letter (in Dutch).
 

The age limits remain the same. The Health Council of the Netherlands will advise on maintaining the maximum possible health benefit through population screening.

It is difficult to say whether a diagnosis would have been different with an earlier invitation. If you suspect that you have been adversely affected by a later invitation, please contact Bevolkingsonderzoek Nederland.
 

You can find more information on this in the labour market briefing. This is available on the page for professionals (in Dutch) under the heading 'Labour market issues in the National Programme for Breast Cancer Screening'.

For more information on the training for new screening technicians, visit the website ‘Working at the National Programme for Breast Cancer Screening (in Dutch)’.

The Centre for Population Screening (BVO NL) has launched a recruitment campaign for training candidates. These candidates are trained as a mammogram technicians and can work in breast cancer screening after their training. In addition, people are recruited who have already completed this training and want to make the transition to screening. The recruitment campaign has been very successful; all available training spots have been filled. At the same time, there is a limit to the number of training spots that we can achieve within the population screening programme. This means it will take several years to recruit and train new employees.

• RIVM has investigated the options for having mammograms carried out by hospital staff. Several hospitals have made an offer for this.
• The Centre for Population Screening has succeeded in establishing a central direction on planning and national policy. There is intensive cooperation between the regions for the distribution of capacity in the country. In addition, there is an exchange of personnel and equipment between the regions.
• People are now receiving open invitations. This means that the full daily capacity can be used and there are hardly any ‘no shows’.
• Participants will also be given more options. They can participate in the screening in various places.