The introduction of colorectal screening in the Netherlands: the interplay between the public opinion and the individual decision making process (WC2014-011)


Starting date: 01/03/2014


Colorectal cancer (CRC) is the second most common cause of cancer-related death in the Western world. After extensive pilot studies, the Dutch government decided to implement a national CRC screening program. From 2014 onwards, all adults between 55 and 76 years of age will be offered a self-administered test which detects invisible traces of blood in faeces. A positive result is followed by colonoscopy to find out whether the participant has colorectal cancer. The Centre for Population Screening of the Dutch National Institute for Public Health (RIVM) coordinates the nationwide implementation of this screening program.

Enabling individuals to make a well-considered decision with respect to participation in CRC screening is considered to be an important quality indicator of the design of screening programs. An often applied concept in regard to this is informed decision making (IDM). Relatively little is known about the way people actually come to a decision towards (CRC) screening. In addition, one can argue that screening decisions are taking place in a wider social context and individual decisions are influenced by social norms and media publicity. It is likely that people use various sources of information to form their decision. The interplay between individual and social factors is likely to shape the strategies people apply in order to make a decision with regard to participation in CRC screening.

This project will focus on identifying the most important individual and social factors at play and on identifying which information(sources) people use when making their decision regarding CRC screening. Further, we will closely examine the choice strategies people apply and the considerations people make. Specific attention will be paid to the relationship between the public opinion and the individual decision making process. We will examine to what extent people feel they made an informed decision and if they feel satisfied about their decision. We’ll be looking at possible differences between subgroups in the population.

This project exists of two parts. Part A targets the monitoring of the nature of the public opinion with respect to CRC screening and the influence of public debate and/or incidents in the (social) media on this public opinion over time. Part B aims to study the decision making process of individuals invited to participate in CRC screening and focuses on identifying the main factors driving this process with respect to CRC screening.