Risk Or Benefit IN Screening for CArdiovascular disease


In 2015, the Dutch large population-based screening trial ‘ROBINSCA: Risk OR Benefit IN Screening for CArdiovascular disease’ started. The ROBINSCA trial received authorization of the Minister of Health, Welfare and Sports, after a positive advice of the Health Council of the Netherlands in August 2013 and received an Advanced Grant by the European Research Committee. The primary objective of the trial is to establish whether screening for CVD by traditional risk factor assessment and/or screening for CAC using CT in asymptomatic men and women followed by preventive treatment, according to prevailing consensus, will reduce coronary heart disease (CHD) related mortality and morbidity by at least 15% compared with the conventional risk factor assessment after 5-years of follow-up. In this trial, approximately 39,000 participants will be included and randomized (1:1:1) into three groups: intervention group A (screening for high-risk of CHD by means of SCORE), intervention group B (screening for high risk of CHD by means of CT scanning for determining the CAC score) or control group (no screening), Currently, three study sites in the Netherlands are participating in this trial: Apeldoorn (Gelre Hospital), The Hague (Bronovo Hospital) and Groningen (University Medical Center Groningen); about 28,000 high risk persons have already been randomized into the trial at this moment. The ROBINSCA will yield the necessary evidence regarding the question whether screening for high risk of CHD will be beneficial in terms of a reduction in non-fatal or fatal events in CHD.

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Microsimulation modeling (MISCAN) will be used to investigate the optimal screening policy for CVD that yields a beneficial trade-off. This model has been built by the main and co-applicant and is internationally used for modeling cancer screening strategies. The use of MISCAN enables the prediction of longer follow-up results on life-years gained, quality-adjusted life-years gained, costs and savings for different scenarios of more individualized screening policies on the individual and population level. These results will be incorporated into future cardiovascular risk management guidelines worldwide to contribute to the risk stratification of asymptomatic subjects, who are currently not considered eligible.


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