WEBVTT 00:00:00.584 --> 00:00:04.042 colorectal cancer screening programme 00:00:04.167 --> 00:00:07.751 For a number of years there's a colorectal cancer screening programme. 00:00:07.876 --> 00:00:09.918 I'm really proud of this. 00:00:10.000 --> 00:00:14.876 It's a screening for citizens between the ages of 55 and 75, once every two years. 00:00:14.999 --> 00:00:20.125 It has enormous benefits. Thousands of cases of cancer are discovered. 00:00:20.250 --> 00:00:26.042 And what's just as important: early stages of cancer are discovered and removed. 00:00:26.167 --> 00:00:29.167 It amounts to a huge benefit for health care. 00:00:33.542 --> 00:00:38.709 We started considering a colorectal cancer screening programme in early 2000... 00:00:38.834 --> 00:00:44.584 because we saw that the number of cases of colorectal cancer was increasing... 00:00:44.709 --> 00:00:47.584 and a great many people were dying from it. 00:00:47.709 --> 00:00:51.918 And this could be prevented by means of an early detection. 00:00:54.667 --> 00:00:58.083 We're responsible for the entire screening programme. 00:00:58.209 --> 00:01:02.042 The Ministry of Health, Welfare and Sport asked us to take charge. What does this entail? 00:01:02.167 --> 00:01:07.250 We're responsible for everything, from funding to patient information. 00:01:07.375 --> 00:01:10.918 And we're keeping contact with the field and the stakeholders. 00:01:11.000 --> 00:01:15.918 Here you can see that it's a very gradual process. 00:01:16.000 --> 00:01:20.584 The Institute for Public Health, in consultation with the ministry, provides the framework... 00:01:20.709 --> 00:01:24.209 for us to execute the screening programme. 00:01:33.626 --> 00:01:36.542 When you're between the ages of 55 and 75... 00:01:36.667 --> 00:01:41.792 we're sending you an early announcement, when you're taking part for the first time. 00:01:43.042 --> 00:01:48.250 This letter tells you that we'll be sending you a purple envelope in a few weeks' time. 00:01:48.375 --> 00:01:53.876 This envelope contains the home test kit, including the special container. 00:01:53.999 --> 00:01:59.959 This is for the stool test, allowing us to test for traces of blood in the stool. 00:02:07.375 --> 00:02:11.667 Every year we invite 2.2 million citizens to participate in the screening. 00:02:13.751 --> 00:02:18.167 In total, some 70% of those people actually take part in the screening. 00:02:19.792 --> 00:02:22.501 They do so by mailing us the stool sample. 00:02:22.626 --> 00:02:29.083 Some 5% of the people sending in the test will have an abnormal result. 00:02:29.209 --> 00:02:32.375 They will then be referred to a treatment centre. 00:02:35.542 --> 00:02:40.584 These respondents will receive a colonoscopy, an internal bowel examination... 00:02:40.709 --> 00:02:43.667 because they have traces of blood in their stool. 00:02:43.792 --> 00:02:50.000 Some 5% of them, which is a rounded-off figure, is indeed diagnosed with colorectal cancer. 00:02:50.125 --> 00:02:55.999 Some 35% of the clients will have large or malignant polyps. 00:02:56.083 --> 00:03:01.792 This is a useful find, because we can then remove them before they develop into cancer. 00:03:04.834 --> 00:03:10.501 There's proof that it's working. We're in effect able to trace people early. 00:03:10.626 --> 00:03:16.125 We're actually tracing people who don't have any complaints or symptoms. 00:03:16.250 --> 00:03:19.459 It's an effective way to trace people... 00:03:19.584 --> 00:03:23.918 and we're able to prevent them from developing colorectal cancer. 00:03:24.000 --> 00:03:30.709 It makes people in the Netherlands healthier and it saves costs in health care. 00:03:30.834 --> 00:03:32.792 So it works both ways. 00:03:37.626 --> 00:03:41.250 The heart of the system is a process database, called ScreenIT. 00:03:41.375 --> 00:03:45.876 This contains the data of all citizens between the ages of 55 and 75. 00:03:45.999 --> 00:03:48.834 They are automatically invited to participate. 00:03:48.959 --> 00:03:52.417 The system starts with an announcement letter. 00:03:52.542 --> 00:03:57.000 Subsequently a parcel will be sent through the mail, containing the test kit. 00:03:57.125 --> 00:04:01.542 Clients will return the container with the stool sample through the mail. 00:04:01.667 --> 00:04:04.167 This will then be sent to a lab. 00:04:04.292 --> 00:04:08.542 The lab will analyse the sample and the result will be entered in ScreenIT. 00:04:08.667 --> 00:04:14.209 We can then judge the result and a letter will be automatically generated... 00:04:14.334 --> 00:04:18.584 telling the client whether the result was normal or abnormal. 00:04:21.626 --> 00:04:26.042 If the result is abnormal, you're immediately referred... 00:04:26.167 --> 00:04:29.667 and an appointment will be made at the hospital. 00:04:31.459 --> 00:04:32.876 Good morning. 00:04:32.999 --> 00:04:36.959 There, you will be informed what the colonoscopy entails. 00:04:37.042 --> 00:04:39.459 This is the intake interview. 00:04:39.584 --> 00:04:43.417 The client will be referred to a colonoscopy centre. 00:04:43.542 --> 00:04:47.999 It's important that this will be a centre close to where you live. 00:04:51.959 --> 00:04:54.417 Good afternoon. Mr Verwey? -That's right. 00:04:54.542 --> 00:05:00.250 Please follow me, we're going to prepare you for the examination. 00:05:01.459 --> 00:05:05.709 The colonoscopy is an examination that will not be easy for everyone. 00:05:10.501 --> 00:05:14.125 Welcome, this is the colonoscopy room. 00:05:14.250 --> 00:05:17.542 If we find polyps in your bowel, we will remove them. 00:05:17.667 --> 00:05:22.292 The doctor will tell you what he has found, and what the test results are. 00:05:22.417 --> 00:05:26.999 The result was positive. It looked perfect. We've removed two polyps. 00:05:27.083 --> 00:05:29.000 The system has been designed... 00:05:29.125 --> 00:05:35.042 in such a way that the client doesn't have to worry about the result for too long. 00:05:35.167 --> 00:05:37.626 For us, the client comes first. 00:05:37.751 --> 00:05:39.999 It wasn't so bad, after all. 00:05:40.083 --> 00:05:46.000 We've taken all quality aspects into account and we've drawn up protocols accordingly. 00:05:46.125 --> 00:05:51.000 Thus, we're gathering even more data, which can be relevant for improvement... 00:05:51.125 --> 00:05:54.125 both in screening and in health care. 00:05:54.250 --> 00:05:58.042 We're approaching things in such a way that everything we do... 00:05:58.167 --> 00:06:03.292 is geared towards making the screening as easy as possible for the client. 00:06:03.417 --> 00:06:09.375 The whole process, including the technology, and the continued wish to improve... 00:06:09.501 --> 00:06:14.375 is a real bonus for us, both as physicians and as researchers. 00:06:14.501 --> 00:06:20.125 I see that all the people involved are very determined, and this really makes me happy.