143 Perceptions and beliefs of GPs on the CSPs Introduction The Dutch government invests considerable budgets, time, and effort in hosting three population-based cancer screening programmes (CSPs), aiming at cervical, breast and colorectal cancer (CRC). The goal of these screening programmes (SPs) is to detect cancer in an early or precursor stage. On average, this approach leads to a better prognosis, as well as fewer and less severe side effects of treatment.1-3 The screening tests of the CSPs are offered free of charge by the Dutch government to all citizens of a specific age and gender. The National Institute for Public Health and the Environment (RIVM) and the national screening organisation (Bevolkingsonderzoek Nederland) are in charge of organizing and coordinating these programmes.4, 5 Participation is voluntary and monitored yearly by the RIVM.6-8 Although the three CSPs exhibit many similarities, each CSP has its unique procedures and organization, mainly due to differences in screening methods (see Table 1). Table 1. Key characteristics of the population-based cancer screening programmes of the Netherlands CC-SP BC-SP CRC-SP 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) Faecal Immunochemical Test (FIT) General practitioner involvement Performing papsmear, discuss outcome, hospital referrala Discuss outcome, hospital referralb Nonec; discuss outcome Screening outcome HPV absent, present or unclear (re-testing). When applicable Pap-classification and HPV-typology. Abnormality absent, abnormality present, not enough information (BI-RADS-code 0-5) Negative (no examination needed), positive (examination needed), unclear (retesting) Financing Invitation, screening test(s) and analyses Dutch government Secondary test(s) and treatment Standard healthcare, hence depending on one’s individual insurance policy CC= Cervical Cancer, BC= Breast Cancer, CRC= Colorectal Cancer, SP= Screening programme, F= Female, M= Male, HPV= Human Papillomavirus 6
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