Report in English with a Dutch summary (KCE reports 45A)

KCE reports vol.45 Screening for Colorectal Cancer: Appendices 127
7.2 THE NETHERLANDS
7.2.1 Average risk groups
In accordance with the advise of the Dutch National Health Council 3, the
national colon carcinoma screenings trial workgroup (COCAST) 518, the Dutch
cancer society working group on colon cancer 519 and the Dutch program for
cancer control 520, a pilot project for colorectal cancer population screening has
been launched on 31 may 2006 for the regions Amsterdam and Nijmegen and
will last for approximately one year o . The aim is to implement a FOBT screening
program in two comprehensive cancer centres 521 and to measure the
effectiveness of the screening program. Within the pilot project 2 different
FOBT s (Hemoccult II and oc-Sensor mu) will be compared to determine which
one is the most appropriate to screen the Dutch population. Additionally, the
project aims at finding out how to improve the screening protocol and how
population screening for colorectal cancer in the Netherlands can be best
organised 2.
The target group includes asymptomatic individuals between 50 and 74. A total
of 20.000 individuals from the above mentioned regions will be invited to
participate in this pilot.
Participants will receive an invitation letter accompanied by an FOTB test,
operation instructions and a leaflet. The FOTB test can be done at home and
has to be sent to the laboratory in a postage free envelope for analysis. Each
participant receives a written result within 2 to 3 weeks. Whenever the result
is positive, the participants GP will receive a copy of the result, and the
participant will be informed that the GP also received this result. Participants
with a positive result are invited for a consultation with a physician researcher
or a nurse researcher in the research unit Amsterdam 522 or Nijmegen 523.
Advice on the interpretation of the result and guidance on advisable follow-up
examinations will be given to the participant. The advised follow-up for
participants with a positive result is through colonoscopy.
Following the second advice of the above mentioned committees, there s a
current study proposal to directly compare FOBT with sigmoidoscopy 524. The
aim of the study is to evaluate the attendance and feasibility of the two forms of
FOBT (a replication of the Dutch FOBT implementation trial in a different
setting), to evaluate the attendance and feasibility of sigmoidoscopy for
screening and to compare the two forms of FOBT and sigmoidoscopy.
In november 2006 a one year pilot population screening project starts in the
region of Rijnmond (Rotterdam and neighbouring villages) 525. 15.000 men and
women aged from 50 to 75 years will be invited for colorectal cancer screening.
The aim of the project is to find out which method is the most appropriate for
a colorectal population screening program. Therefore individuals from the
target group are randomly allocated into 3 groups. Two groups will receive a
home test kit with 2 different FOBT s for each group. The third group will be
invited for sigmoidoscopy. Results are expected by the end of 2007.
o The project is a collaboration of the departments stomach-, bowel and liver diseases of the
Academic Medical Centre Amsterdam (AMC), the universitary Medical centre St Radboud Nijmegen
(UMCN), the integral cancer centre Amsterdam (IKA) and the integral cancer centre East (IKO). The
project is financed by ZonMW, the Netherlands organisation for health research and development