Anticipating implementation of colorectal cancer screening in The Netherlands: a nation wide survey on endoscopic supply and demand

All Dutch endoscopy units (N = 101) were surveyed for manpower and the numbers of endoscopy procedures performed in 2009. Based on calculations in the report issued by the Dutch Health Council, future additional workload caused by faecal immunochemical test (FIT) screening was estimated. The number of colonoscopies performed in Europe was evaluated by a literature search and an email-inquiry.Compared to 2004, there was a 24% increase in total endoscopies (N = 505,226 in 2009), and a 64% increase in colonoscopies (N = 191,339 in 2009) in The Netherlands. The number of endoscopists had increased by 4.6% (N = 583 in 2009). Five years after stepwise implementation of FIT-based CRC screening, endoscopic capacity needs to be increased an additional 15%. A lack of published data on the number of endoscopies performed in Europe was found. Based on our email-inquiry, the number of colonoscopies per 100,000 inhabitants ranged from 126 to 3,031 in 15 European countries.Over the last years, endoscopic procedures increased markedly in The Netherlands without a corresponding increase in manpower. A FIT-based CRC screening program requires an estimated additional 15% increase in endoscopic procedures. It is very likely that current colonoscopy density varies widely across European countries.The demand for gastrointestinal endoscopic procedures and gastroenterological care in The Netherlands and surrounding countries has been steadily increasing over the years [1]. Demographic changes due to an aging population and technical developments like video capsule endoscopy, double balloon endoscopy, and magnifying techniques, are likely to have contributed to this increase in workload. The existing shortage of gastroenterologists and endoscopy staff in The Netherlands is clear from waiting lists and vacancies [1]. This shortage is likely to be compounded by the implementation of a nationwide screening program for colorectal cancer (CRC), as it would lead to a further increase in endoscopi