The very first screening programme in the Netherlands started around 1950, after which many more screening programmes followed. RIVMNational Institute for Public Health and the Environment has been coordinating all of these programmes since 2006. A brief historic overview and recent innovations are highlighted in timelines.

A brief history

Many screening programmes were introduced between 1950 and 2000. Pregnant women have been screened since 1950 to determine their blood group and detect syphilis infections. Starting in 1970, smear tests have been carried out on a large scale to detect cervical cancer. A nationwide uniform coordinated population screening programme for cervical cancer was introduced years later, in 1996. With the screening on the disease PKU the newborn blood spot screening started in 1974 and more than 20 diseases were added in the following years.

The central coordination granted to the RIVMNational Institute for Public Health and the Environment in 2006 facilitated the introduction of more screening programmes, such as the hearing screening. Colorectal cancer screening, introduced in 2014, is the most recent addition.

This figure shows all screenings present at this moment in the Netherlands and their year of nationwide implementation.  The prenatal screening for infectious diseases and irregular erythrocyte antibodies started in 1950. The prenatal 20 week structural ultrasound scan started in 2007.  The prenatal screening for Down’s, Edward’s and Patau’s syndrome started in 2007. The newborn blood spot screening started in 1974. The newborn hearing screening started in 2006. The cervical cancer screening started in 1970

Click here for an extended version of this figure with detailed information about the significant developments in each screening programme

Innovation

hrHPV screening for cervical cancer

In 2017 the Netherlands became the first country to introduce a national uniform cervical cancer screening programme based on primary hrHPV screening. In this new programme, the cytology of the material is only assessed after the smear has tested positive for hrHPV. For women who do not want to go to the GP for a smear test, a self-sampling kit was introduced in 2017. The test kit is sent to the woman’s home address and aims to lower barriers for participation.

Expansion of the newborn blood spot screening

In 1974, the newborn blood spot screening (heel prick test) was implemented. The number of diseases screened for has increased in the subsequent years. Most recently, in 2019, three metabolic diseases were added to the screening which brings the total amount of diseases screened on 22. The expansion of this screening results in health gain since more diseases can be detected and prompt treatment can be given to newborns. Over the coming years, more diseases will be added. Given its current package (supplemented with hearing screening), the Netherlands ranks highly in Europe among the countries that screen for the largest number of disorders.

An exploration of the 13-week ultrasound scan

The Dutch Ministry of Health, Welfare and Sport plans to start a national scientific study into the introduction of an ultrasound scan around the 13th week of pregnancy. Some of the abnormalities that are now visible in the 20-week ultrasound scan can actually be discovered earlier, at around 13 weeks. An exploratory investigation recommends making the 13-week ultrasound scan available to all pregnant women free of charge. Although no decision has yet been taken with regard to funding the study, all of the parties involved seem to have sufficient capacity to carry out this scientific study. The planning aims to start the study into the 13-week ultrasound scan at the beginning of 2021.