When you want to do more prevention you must reach the people who need screening and have the right tools to make the process work smoothly. That's why the Caribbean Prevention Center and Topicus are collaborating on a breast cancer screening pilot in Curaçao, using the PreventUs platform to detect cancer earlier and more effectively.
After almost a year of preparation, the breast cancer screening pilot launched in Curaçao in October 2024. For the Caribbean Prevention Center, it marks a significant leap forward in making breast cancer prevention more accessible. For Topicus, it's a milestone as their first international deployment of their PreventUs screening platform. We spoke with Soraya Verstraeten, Quality Manager at the Caribbean Prevention Center (known locally as Fundashon Prevenshon), and Rutger Kerkhof, Topicus Project Leader, about the implementation.
Soraya, what was breast cancer prevention like in Curaçao before this?
"Fundashon Prevenshon launched one of the first organized breast cancer prevention programs in the region back in 2010. But our screening participation was quite low: only 40%, compared to 65-70% in the Netherlands. We tried everything: offering free transportation and taking our mobile unit into different neighborhoods to raise awareness about our prevention programs."
Why was participation so low?
"We'd adopted the Dutch best practice of sending periodic screening invitations by mail. But when we called 120 women three months after mailing their invitations, we discovered that fewer than 60% had even received the letter. That's when we realized a digital approach might work far better here. Most people have mobile phones and email addresses, so now we're testing through way.
We also realized our workflow system wasn't adequate anymore. You need robust workflow software. It's essential for supporting our front desk staff, administrators, screening technicians and radiologists, plus it gives you the management data you need to track program performance and make improvements. So we looked for a partner who could help with process support, management information, and figuring out the best way to reach our target population. That's how we found Topicus and PreventUs."
How's it been working with Topicus?
"Nothing but praise so far. They really know their stuff, but they're also genuinely pleasant people to work with. What really stands out is how well they listen and collaborate. For example, they initially suggested a 'train the trainer' program, but we felt that wouldn't fit our small-scale operation. So Rutger developed a customized training series instead, where my colleagues could actively contribute. That gave them real ownership of the project and generated much more internal enthusiasm. That's collaboration done right: we were heard, and they acted on our feedback. Now colleagues keep asking when we'll roll out PreventUs for our colorectal and cervical cancer screening programs too."
What are the goals of this pilot?
"We're addressing two research questions. The first focuses on the invitation process. We have about 3,000 women in our target group, and we're testing three invitation methods: postal mail, email, and WhatsApp. We want to find out which method gets the best response rate and is most effective at reaching people. We need to ensure invitations are received and women are properly informed.
The second question is whether Curaçao should start mammography screening at age 40, alongside our existing program for ages 45-75. Regional health organizations have found that breast cancer occurs at younger ages in our region, so we're investigating whether earlier screening makes clinical sense. Based on participation rates and cancer detection, we'll evaluate if it's worth expanding the program. While the pilot isn't specifically testing the workflow system, we'll eventually use those insights to streamline our core processes."
Any advice for healthcare quality managers?
"Data is crucial for monitoring and evaluating programs, but never lose sight of the actual patient. They're why we do this. I deliberately keep my office downstairs near reception so I can see what's happening. For example when we're getting too busy or if someone's frustrated at the desk. It keeps you grounded in who you're serving."
Project leader Rutger Kerkhof has been involved since January 2024. While much of the work happened remotely, Rutger and his colleague Wesley Oosting traveled to Curaçao in October 2024 to finalize the implementation.
How do you look back on this phase Rutger?
"It's a big deal for us. PreventUs's first implementation outside the Netherlands. You notice that with the time difference. Curacao is six hours behind us, so you have to be mindful about scheduling calls or when you're sending emails. But we managed to work around it well."
What stage is the pilot at?
"We've scheduled the first 400 appointments through December. The first screenings for younger women start November 21st 2024. If everything goes according to plan, the first woman will walk through the door at 7:30 AM that morning for her mammogram."
How is the collaboration with Caribbean Prevention Center for Topicus?
"It's been excellent. What struck us most was their passion. People have these intense, substantive discussions about the work. You can see how much they care. The energy around this pilot is incredible."
What else stuck with you from your time in Curaçao?
"The multilingualism is impressive: Dutch, English, Spanish, Papiamentu. Sometimes someone understands your Dutch perfectly but you notice it's better to switch to English anyway. And Wesley and I quickly understood why postal delivery is unreliable. On one of our walks, we noticed the house numbering: one, two, three, eight, twelve, thirty-eight, seventeen, forty-five. No wonder mail won’t be delivered!"
Any advice for colleagues?
"A while back, I told Topicus Healthcare I'd be interested if any international projects came up. They warned me that international work requires patience, but I was fine with that. And then this opportunity came along. My point is: don't be afraid to say what you want. It can really pay off."
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