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Country fact sheet: Belgium

Population

- Total population: 11 338 476
- Female population: 5 757 459
- Male population: 5 581 017
The World Bank (2016)

Health Expenditure

- Total per capita (US$): 4 228.3
- Out-of-pocket (% of total expenditure on health): 17.6
World Health Organization (2015)

Human Development Index

- HDI: 0.896
- Category: Very high
UNDP Human Development Report (2015)

Geography

Life Expectancy at Birth

- Total population (years): 81.0
- Female population (years): 83.4
- Male population (years): 78.7
The World Bank (2016)

Cancer Burden

- Overall cancer incidence (rate per 100 000 persons per year): 345.8
- Overall cancer mortality (rate per 100 000 persons per year): 103.0
- Most common cancer site by incidence for females (rate per 100 000 persons per year): Breast (113.2)
- Most common cancer site by mortality for females (rate per 100 000 persons per year): Breast (16.3)
- Most common cancer site by incidence for males (rate per 100 000 persons per year): Prostate (65.5)
- Most common cancer site by mortality for males (rate per 100 000 persons per year): Lung (37.6)
- GLOBOCAN 2018 population fact sheet
GLOBOCAN (2018)

BREAST CANCER SCREENING PROGRAMME

Last updated year for qualitative data: 2016
Source of data: Report (EU Report 2017)
Last updated year for quantitative data: 2013
Source of data: Report (EU Report 2017)

Screening protocol

Year published/updated: No answer
Target age (min-max) and screening interval [months] for each test: Mammography
(50-69 years / [24 months] )

Programme status and organization

Dedicated person/team to coordinate the programme: Yes
Budget line for screening programme: Yes
Documented cancer screening policy: Yes
Nature of documentation of the policy: Law
Program introduction was preceded by a pilot: No answer
Year program was initiated: 2001
Screening tests provided free of charge: Yes
Diagnostic tests provided free of charge: No
Treatment services provided free of charge: No answer

Information system/Data collection

Data type collected by the programme: Individual and aggregate
The information system collects data outside the program (opportunistic screening/private sector): No answer
Cancer screening registries covering the entire country/region: Yes
Cancer screening data is linked with Population-based cancer registry: Yes

Invitation to screening and further assessment

Method of identification of eligible individuals: From population data
Source of population data: Population register
Annual target for screening coverage: No answer
Invitations to eligible population: Yes, For the entire target population
Method of invitation: letter
Screen positive individuals actively invited for further assessment: Yes
Individuals with a precancer or cancer diagnosis actively contacted: No answer
Program collects data on the treatment of precancer/cancers: No answer

Programme monitoring and quality assurance (QA)

Documented standard operating procedure/policy for QA: No answer
Responsible person/team for QA: Yes
Documented performance indicators and their reference standards to assess the programme: No answer
Evaluation reports are prepared and published: Yes

Cancer Screening programme status

Nature of cancer screening programme: Population-based
Current status of implementation (applicable only for population-based programmes): Roll-out completed
Cancer screening programme population based for selected populations: No answer

Performance indicators

Target age and regional limitation if applicable: 50-69 years for Flanders
Invitation coverage (%): 100.1
Examination coverage (%): 50.2
Participation rate (%): 48.6
Completeness of data related to screening results (%): 100.2
Completeness of data related to further assessment results (%): 89.5
Further assessment rate (%): 2.6
Further assessment participation rate (%): 91.7
Detection rate of CIS and invasive (x 1000): 5.32
Detection rate of invasive cancer (x 1000): 0.99
Positive predictive value of further assessment to detect CIS and invasive (%): 22.6
Proportion of total carcinomas which are CIS (%): 18.6
Benign surgical biopsy rate (x 1000): 0.17
More quantitative data (Brussels: 2013)
More quantitative data (Flanders: 2014)
More quantitative data (Wallonia: 2013)



CERVICAL CANCER SCREENING PROGRAMME

Last updated year for qualitative data: 2016
Source of data: Report (EU Report 2017)
Last updated year for quantitative data: 2014
Source of data: Report (EU Report 2017)

Screening protocol

Year published/updated: No answer
Target age (min-max) and screening interval [months] for each test: Cytology
(25-64 years / [36 months] )
Triaging test used: None
"screen and treat" included in the protocol: No answer

Programme status and organization

Dedicated person/team to coordinate the programme: Yes
Budget line for screening programme: Yes
Documented cancer screening policy: Yes
Nature of documentation of the policy: Official recommendation
Program introduction was preceded by a pilot: No answer
Year program was initiated: 2013
Screening tests provided free of charge: Yes
Diagnostic tests provided free of charge: Yes
Treatment services provided free of charge: No answer

Information system/Data collection

Data type collected by the programme: Individual and aggregate
The information system collects data outside the program (opportunistic screening/private sector): No answer
Cancer screening registries covering the entire country/region: Yes
Cancer screening data is linked with population-based cancer registry: Yes

Invitation to screening and further assessment

Method of identification of eligible individuals: From population data
Source of population data: Population register
Annual target for screening coverage: No answer
Invitations to eligible population: Yes, Excluding those covered by opportunistic screening
Screening kit included with the invitation: No
Method of invitation: letter, email
Screen positive individuals actively invited for further assessment: No
Individuals with a precancer or cancer diagnosis actively contacted: No answer
Program collects data on the treatment of precancer/cancers: No answer

Programme monitoring and quality assurance (QA)

Documented standard operating procedure/policy for QA: No answer
Responsible person/team for QA: Yes
Documented performance indicators and their reference standards to assess the programme: No answer
Evaluation reports are prepared and published: Yes

Cancer Screening programme status

Nature of cancer screening programme: Population-based and non population-based
Current status of implementation: Roll-out on going
Cancer screening programme population based for selected populations/regions: No answer

Performance indicators

Target age and regional limitation if applicable: 30-59 years (Flanders)
Invitation coverage (%): 58.9
Examination coverage (invitation cohort) (%): 7.4
Examination coverage (tests in the index-year) (%): 41.8
Participation rate (%): 11.6
Completeness of data related to screening test results (%):
Completeness of data related to further assessment results (%):
Colposcopy referral rate (%):
Colposcopy participation rate (%):
Detection rate of CIN2+ (x 1000):
Detection rate of CIN3+ (x 1000):
Positive Predictive Value of abnormal screening test to detect CIN2+ (x 1000):
Positive Predictive Value of CIN3+ (x 1000):
More quantitative data (Flanders: 2014)



COLORECTAL CANCER SCREENING PROGRAMME

Last updated year for qualitative data: 2014
Source of data: Report (EU Report 2017)
Last updated year for quantitative data: 2014
Source of data: No source

Screening protocol

Year published/updated: No answer
Target age (min-max) and screening interval [months] for each test: FIT: (50-74 years / [24 months] )
Colonoscopy: (- years / [120 months] )

Programme status and organization

Dedicated person/team to coordinate the programme: Yes
Budget line for screening programme: Yes
Documented cancer screening policy: Yes
Nature of documentation of the policy: Official recommendation
Program introduction was preceded by a pilot: No answer
Year program was initiated: 2009
Screening tests provided free of charge: Yes
Diagnostic tests provided free of charge: Yes
Treatment services provided free of charge: No answer

Information system/Data collection

Data type collected by the programme: Individual and aggregate
The information system collects data outside the program (opportunistic screening/private sector): No answer
Cancer screening registries covering the entire country/region: Yes
Cancer screening data is linked with population-based cancer registry: Yes

Invitation to screening and further assessment

Method of identification of eligible individuals: From population data
Source of population data: Population register
Annual target for screening coverage: No answer
Invitations to eligible population: Yes, For the entire target population
Method of invitation: letter
Screen positive individuals actively invited for further assessment: No
Individuals with a precancer or cancer diagnosis actively contacted: No answer
Program collects data on the treatment of precancer/cancers: No answer

Programme monitoring and quality assurance (QA)

Documented standard operating procedure/policy for QA: Yes
Responsible person/team for QA: Yes
Documented performance indicators and their reference standards to assess the programme: Yes
Evaluation reports are prepared and published: Yes

Cancer Screening programme status

Nature of cancer screening programme: Population-based
Current status of implementation (applicable only for population-based programmes): Roll-out completed
Cancer screening programme population based for selected populations: No answer

Performance indicators

FIT gFOBT sigmoidoscopy Colonoscopy
Target age and regional limitation if applicable: 50-74 (Flanders) 50-74 (Wallonia)
Invitation coverage (%): 93.0 123.8
Examination coverage (%): 46.7 5.6
Participation rate (%): 50.3 4.5
Completeness of data related to screening results (%): 100.0 97.9
Completeness of data related to information about attendance to colonoscopy assessment (%): 100.0 100.1
Completeness of data related to histology result (%): 100.0 82.3
Screen positivity (indication for follow-up colonoscopy) rate (%) : 8.1 3.9
Follow-up colonoscopy participation rate (%): 36.3 72.6
Completion rate follow-up colonoscopy (%): 98.5 98.5
Detection rate of adenomas (x 1000): 6.8
Detection rate of advanced adenomas (x 1000): 4.75
Detection rate of colorectal cancers (x 1000): 2.0
Positive Predictive Value of further assessment to detect adenomas (%): 23.1
Positive Predictive Value of further assessment to detect advanced adenomas (%): 16.0
Positive Predictive Value of further assessment to detect colorectal cancers (%): 6.7
More quantitative data for FIT (Male - Flanders: 2014)
More quantitative data for FIT (Women - Flanders: 2014)
More quantitative data for gFOBT (Male - Wallonia: 2014)
More quantitative data for gFOBT (Women - Wallonia: 2014)