This year marks the 25th anniversary of the Dutch national breast cancer screening programme. A major change during those 25 years was the transition from analogue to digital images. The digitisation process was started in 2008 and completed in June 2010. The results of the changeover are now known. Especially in women under the age of 60, the proportion of breast cancers being detected early has risen. The data also confirm that breast cancer is increasingly common in the 50 to 75 year-old target group.
Since the programme began, more than 17 million screening tests have been carried out in almost 3.5 million women. The aim of this screening is to detect breast cancer at an early stage, increasing the likelihood of successful treatment. Breast cancer is common and large numbers attend screening regularly; as a result, almost 100,000 women in the Netherlands have been diagnosed to date.
Decrease in breast cancer mortality
If breast cancer is found early, the chances of survival are
higher. At this stage there is often a wider range of treatment
options and they are more likely to be less invasive. The prospects
for women with breast cancer have improved enormously over the
years. Since population screening was introduced, deaths in the
Netherlands due to breast cancer have fallen by 37% thanks to both
the screening programme and increasingly effective treatments. As a
result of the programme, around 775 fewer women are dying from
breast cancer each year.
Population screening has disadvantages as well as benefits. For
example, women can find the screening painful. The programme is
keeping close track of efforts to develop less painful methods of
breast cancer screening. It is also working to improve coordination
with hospitals, reducing the period of uncertainty for women
recommended for referral.
The Dutch system is unique
It is important to assess the Dutch screening results in
isolation. As a complete system, the Dutch programme cannot easily
be compared with results or studies from other countries. The
Health Council of the Netherlands assessed the Dutch system last
year and concluded that population screening is worthwhile. Within
Europe, the Dutch programme is regarded as a very thorough and
high-quality system. The credit for this goes to the more than
1,000 people behind the scenes, ranging from logistics planners,
ICT specialists and phone line staff to laboratory technicians in
67 screening units and the radiologists themselves. The commitment
of all staff involved and the organisation of the whole complex
system are reasons to be proud of the Dutch programme. With its
excellent screening performance, high participation rates and huge
impact on society, the programme makes a vital contribution to
public health in the Netherlands.
Centre for Population Screening coordinates and directs the breast
cancer screening programme on behalf of the Ministry of Health,
Welfare and Sport (VWS). The programme is implemented by five
established regional screening providers. Its quality and
effectiveness are monitored closely by the Dutch reference centre
for screening in Nijmegen (LRCB) and the National Evaluation Team
(NETB) of Erasmus University Rotterdam and Radboud University
Nijmegen. Many other parties also contribute to the breast cancer
screening programme, including the Dutch College of General
Practitioners (NHG), the professional associations of radiologists
(NVVR) and laboratory technicians (NVMBR), the patient support
organisation BorstkankerVereniging Nederland (BVN) and doctors from
the hospital breast cancer clinics.