Image: ©RIVM

Evaluation and optimisation of the colorectal cancer screening programme

The colorectal cancer screening programme was introduced gradually from 2014. Since 2019, all people aged 55 to 75 have been invited to participate once every two years. In 2021, more than 1.6 million people took part in the screening programme, and colorectal cancer was detected in 2,700 participants, with an early stage of colorectal cancer being detected in 17,000 participants. At this stage, the screening programme has been running for too short a time to be able to scientifically demonstrate that it leads to less mortality from colorectal cancer; however, there are clear indications in that direction. Under the current circumstances, the benefits (prevention of colorectal cancer and associated mortality) outweigh the risks of the screening programme (screening test that detects no abnormalities but is taxing and causes concern, and cases of cancer that are missed). The Council therefore recommends that no modifications be made to the regular programme at this time.

The Council does, however, recommend conducting a regional pilot population screening programme with one-off screening of people around 50 years of age. This will allow a review of to what extent such a programme would provide health benefits and whether the benefits would outweigh the risks. Based on the results, a decision can be made as to whether the age limit of the programme should be lowered. One promising development that may improve the screening programme in the long term is customised screening. As such, the Council recommends that this be reviewed. In addition, the Council recommends continuing investment in increasing participation rates.