Dutch health authorities launch local outreach to boost cancer screening participation

The Netherlands is seeing a worrying drop in participation in cancer screening programs, prompting the National Institute for Public Health and the Environment (RIVM) to intensify efforts to inform more residents about early detection of cancer, especially in communities with lower turnout, according to NOS.

RIVM’s Patricia Hugen, program manager for cancer screenings, acknowledged the challenges: “We are not reaching everyone well with our information. It is not a problem if people consciously choose not to participate, but we know there are Dutch residents who do not take part despite having a positive attitude toward the screenings.”

The national cancer screening programs cover colorectal, breast, and cervical cancers. These screenings target individuals without symptoms to detect cancer or precancerous stages early, aiming to improve prevention and treatment outcomes.

To counteract the decline in attendance, the RIVM has launched a series of pilot projects in 2024 and 2025 focusing on neighborhoods with large populations of non-Western migrants and residents with lower socioeconomic status—groups known to participate less often.

One key approach is neighborhood-centered information sessions organized by the RIVM at local community centers. “Some attendees never opened the invitation envelopes or the screening kits before,” Hugen told NOS. “During these meetings, they become interested, want to learn more, and decide to participate. We also help them practically with the process.”

In addition to these sessions, the RIVM distributed new, clearer brochures to 400 general practitioners’ offices located in areas with low participation rates. “All the brochures were taken,” Hugen said. “About 100 other practices, having heard about the brochures, also requested them.”

Beyond direct outreach, the RIVM is investing in training local “key persons”—such as health ambassadors, neighborhood volunteers, and community leaders—so they can continue holding information sessions independently after the pilots end this year.

Angelique Harbers, a RIVM educator involved in the training, told NOS, “For example, I have trained mosque leaders in Limburg. They tell me, ‘If I tell men this is an important and good screening, they trust me. If you say it, they listen differently.’ I believe it has more and lasting impact when information comes from people within the community who share the same background and beliefs.”

Despite these efforts, it remains uncertain whether participation rates will rise significantly. Hugen noted, “We focus mainly on making our information more accessible, but there are many reasons why people do not participate.”

She highlighted demographic changes as a factor: “More non-Western migrants are now within the screening target groups. At the same time, mistrust of institutions and financial concerns can play roles—for example, people worry about the financial consequences if cancer is diagnosed.”

Importantly, the RIVM has not set strict targets for increasing participation rates nationwide. “Our goal is not to pressure people to participate. However, based on the positive feedback we receive, we expect attendance to rise locally,” Hugen said.