The very first screening (onderzoek) programme in the Netherlands started around 1950, after which many more screening programmes followed. RIVM (Rijksinstituut voor Volksgezondheid en Milieu) has coordinated all of these programmes since 2006. The institute is constantly looking for ways to improve the current programmes and implement new screenings. A brief historic overview and recent innovations are highlighted below.
A brief history of screening
Many screening (onderzoek) 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.
The central coordination granted to the RIVM (Rijksinstituut voor Volksgezondheid en Milieu) in 2006 facilitated the introduction of more screening programmes, such as the heel prick and hearing screening. Bowel cancer screening, introduced in 2014, is the most recent addition.
Innovation
hrHPV screening (onderzoek) 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 increase the participation rate.
Expansion of the heel prick
In 1974, the new-born blood spot screening was implemented. The number of diseases screened for has increased in the subsequent years. Most recently, three metabolic diseases were added to the screening. 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, a total of nine 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 investigationrecommends 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 end of 2020.