12 Chapter 1 Table 1. Key characteristics of the current CSPs in the Netherlands Cervical CSP Breast CSP Colorectal CSP Available since (year) 1979 (pilots from 1976) 1990 (pilots from 1984) 2014 (fully operational since 2019) Population Age boundaries 30-60 50-75 55-75 Sex F F F + M Interval (years) 5 2 2 Screening test HPV-test, if HPV positive then cytology (Pap-smear) Mammography (bilateral) FIT GP involvement Performing Pap-smear, discuss outcome, hospital referrala Discuss outcome, hospital referralb Nonec; discuss outcome Screening outcome HPV absent, present or unclear (re-testing). When applicable Papclassification and HPV-typology Abnormality absent (BI-RADS 1-3), abnormality present (BI-RADS 4-5), not enough information (BI-RADS 0) Negative (no examination needed), positive (examination needed), unclear (re-testing) Financing Invitation, screening test(s) and analyse Dutch government Secondary test(s) and treatment Standard healthcare, hence depending on one’s individual insurance policy CSP= Cancer Screening Programme, F= Female, M= Male, HPV= Human Papillomavirus, GP= General Practitioner, FIT= Faecal Immunochemical Test a From 2017 onward, women can opt to receive a self-sampling test (after being invited). The outcome of the self-sampling test is not automatically shared with the GP due to privacy legislation. Outcomes will only be shared with the GP, if it is explicitly stated that the GP is allowed to receive this information. Hence, the GP no longer plays an essential role in this CSP. If HPV is detected, women are recommended to contact their GP to have a smear test taken at the GP-practice. b In cases no abnormalities are detected, the GP will not be involved. c Since 2017 the GP no longer automatically receives the outcome of a FIT. Outcomes will only be shared with the GP if it is explicitly stated that the GP is allowed to receive this information. After a positive FIT patients are encouraged to seek contact with their GP. When a patient visits the GP, he/she can provide an overview of a patient’s medical record, which the colonoscopy centre could ask for.
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