colorectal cancer screening programme
For a number of years there's a colorectal cancer screening programme.
I'm really proud of this.
It's a screening for citizens between the ages of 55 and 75, once every two years.
It has enormous benefits. Thousands of cases of cancer are discovered.
And what's just as important: early stages of cancer are discovered and removed.
It amounts to a huge benefit for health care.
We started considering a colorectal cancer screening programme in early 2000...
because we saw that the number of cases of colorectal cancer was increasing...
and a great many people were dying from it.
And this could be prevented by means of an early detection.
We're responsible for the entire screening programme.
The Ministry of Health, Welfare and Sport asked us to take charge. What does this entail?
We're responsible for everything, from funding to patient information.
And we're keeping contact with the field and the stakeholders.
Here you can see that it's a very gradual process.
The Institute for Public Health, in consultation with the ministry, provides the framework...
for us to execute the screening programme.
When you're between the ages of 55 and 75...
we're sending you an early announcement, when you're taking part for the first time.
This letter tells you that we'll be sending you a purple envelope in a few weeks' time.
This envelope contains the home test kit, including the special container.
This is for the stool test, allowing us to test for traces of blood in the stool.
Every year we invite 2.2 million citizens to participate in the screening.
In total, some 70% of those people actually take part in the screening.
They do so by mailing us the stool sample.
Some 5% of the people sending in the test will have an abnormal result.
They will then be referred to a treatment centre.
These respondents will receive a colonoscopy, an internal bowel examination...
because they have traces of blood in their stool.
Some 5% of them, which is a rounded-off figure, is indeed diagnosed with colorectal cancer.
Some 35% of the clients will have large or malignant polyps.
This is a useful find, because we can then remove them before they develop into cancer.
There's proof that it's working. We're in effect able to trace people early.
We're actually tracing people who don't have any complaints or symptoms.
It's an effective way to trace people...
and we're able to prevent them from developing colorectal cancer.
It makes people in the Netherlands healthier and it saves costs in health care.
So it works both ways.
The heart of the system is a process database, called ScreenIT.
This contains the data of all citizens between the ages of 55 and 75.
They are automatically invited to participate.
The system starts with an announcement letter.
Subsequently a parcel will be sent through the mail, containing the test kit.
Clients will return the container with the stool sample through the mail.
This will then be sent to a lab.
The lab will analyse the sample and the result will be entered in ScreenIT.
We can then judge the result and a letter will be automatically generated...
telling the client whether the result was normal or abnormal.
If the result is abnormal, you're immediately referred...
and an appointment will be made at the hospital.
Good morning.
There, you will be informed what the colonoscopy entails.
This is the intake interview.
The client will be referred to a colonoscopy centre.
It's important that this will be a centre close to where you live.
Good afternoon. Mr Verwey? -That's right.
Please follow me, we're going to prepare you for the examination.
The colonoscopy is an examination that will not be easy for everyone.
Welcome, this is the colonoscopy room.
If we find polyps in your bowel, we will remove them.
The doctor will tell you what he has found, and what the test results are.
The result was positive. It looked perfect. We've removed two polyps.
The system has been designed...
in such a way that the client doesn't have to worry about the result for too long.
For us, the client comes first.
It wasn't so bad, after all.
We've taken all quality aspects into account and we've drawn up protocols accordingly.
Thus, we're gathering even more data, which can be relevant for improvement...
both in screening and in health care.
We're approaching things in such a way that everything we do...
is geared towards making the screening as easy as possible for the client.
The whole process, including the technology, and the continued wish to improve...
is a real bonus for us, both as physicians and as researchers.
I see that all the people involved are very determined, and this really makes me happy.