Henricus J. de Koning, MD, PhD

dekoning 210x210
Deputy Head, Public Health and Screening Evaluation,
Department of Public Health, Erasmus MC


Work Experience and Appointments Since Graduation

1986 – 1987 Teaching Anatomy and Pathology to nurses 

1987 – 1995 Researcher, Department of Public Health, Erasmus University Rotterdam.

1995 – 1999 Assistant professor, Department of Public Health, Erasmus University Rotterdam.

1999 – 2008 Associate professor, Department of Public Health, Erasmus University Rotterdam.

2008 – present Professor of Public Health & Screening Evaluation, Department of Public Health, Erasmus MC. Inaugural address:  De mysterieuze massa; The mysterious mass(es). 26th June 2009.

2011 – 2012 Senior Associate Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.             

2011 – 2017 Member Medical Advisory Board of the Royal Netherlands Academy of Arts and Sciences (KNAW).


Brief Summary of Research        

I am Deputy Head and Professor of Public Health & Screening Evaluation, Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.

My major scientific contributions are in the areas of (1) designing, running and evaluating (often large-scale) multidisciplinary population-based randomized controlled screening trials to establish the efficacy of screening, (2) evaluating active (inter-)national screening programs and clinical tests to establish effectiveness and (3) guiding public health policies on screening and primary prevention using predictions of favourable and unfavourable effects and the cost of interventions, based on micro-simulation modelling of the natural history of disease, risk-prediction modelling and cost-effectiveness and cost-utility analyses. Our multidisciplinary and international research results in recommendations on whether or not to introduce screening, surveillance or other preventive interventions for specific diseases and on policy decisions to introduce it in specific ways, either at population level or in (high risk) patients.

My PhD on the cost-effectiveness of breast cancer screening was one of the first Health Technology Assessments in the Netherlands, and one of the first on breast cancer screening in the world. It was the first to include the unfavorable effects of screening into such an analysis and led to the design and implementation of the Dutch program. I had a shared responsibility for designing the ERSPC trial on prostate cancer screening, which included establishing the screening interval, core age groups, power and monitoring plan (secretary Data Monitoring Committee), and set up and chaired the international committee charged with reviewing the primary outcome of the trial. I am PI of the NELSON lung cancer screening trial and designed the entire trial in all its facets (sole trial with different screening intervals). This trial was the first to show that lung nodules detected by CT scanning can be managed safely with conservative follow-up schedules when including volume-doubling times in the algorithm, and is the largest trial without screening in the control arm. I was PI of the sole RCT on screening for language disorders in 11,000 toddlers, and am PI of the ROBINSCA trial through an Advanced Researcher Grant (2011), to assess the (cost-) effectiveness of screening for cardiovascular disease.

We are further responsible for the monitoring and evaluation of the Dutch Breast, Cervical and Colorectal Cancer Screening Program, and presently have HORIZON2020-projects to evaluate breast, cervical and colorectal cancer screening in Europe (coordinator), and evaluate (and implement) vision and hearing screening in Europe (substitute coordinator). We are co-PI in 7 CISNET (NIH/NCI-funded) projects, aimed at modelling and predicting the impact of interventions in breast, prostate, lung, colorectal, esophageal, colorectal and cervical cancer. These have led to substantial influences in policy making, perhaps most prominently our recent analyses on lung cancer screening for the USPSTF, which have led to insurance coverage of low-dose CT screening according to our recommended eligibility in the US. Much of our work also has direct implications to patient care, e.g., in the guidelines of the British Thoracic Society on pulmonary nodules, legislation in screening for child abuse at emergency departments, guidelines evaluating screening for late-effects in children treated for cancer, MRI-guidelines for high risk breast patients, surveillance guidelines after adenoma detection, eligibility criteria for Active Surveillance in prostate cancer patients, trial criteria for breast cancer patients with ductal carcinoma in situ (DCIS) and prenatal screening.


11 Key Publications that Show Some of the Variety in Research:

  1. Koning, HJ de, van Der Aalst CM, de Jong PA, Scholten ET, Nackaerts K, Heuvelmans MA, Lammers JWJ, C. Weenink, Yousaf-Khan U, Horeweg N, Van’T Westeinde S, Prokop M, Mali WP, Mohamed Hoesein FAA, van Ooijen PMA, Aerts JGJV, den Bakker MA, Thunnissen E, Verschakelen J, Vliegenthart R, Walter JE, ten Haa K, Groen HJM, and Oudkerk M. Reduced Lung-Cancer Mortality with Volume Ct Screening in a Randomized Trial. New England Journal of Medicine 2020; 382 (6): 503-13. http://dx.doi.org/10.1056/NEJMoa1911793.
  1. Denissen SJ, van der Aalst CM, Vonder M, Oudkerk M, de Koning HJ. Impact of a cardiovascular disease risk screening result on preventive behaviour in asymptomatic participants of the ROBINSCA trial. Eur J Prev Cardiol. 2019 Aug;26(12):1313-1322. doi: 10.1177/2047487319843396. Epub 2019 Apr 9.
  1. Heijnsdijk EAM, Wever EM, Auvinen A, Hugosson J, Ciatto S, Nelen V, Kwiatkowski M, Villers A, Páez A, Moss SM, Zappa M, Tammela TLJ, Mäkinen T, Carlsson S, Korfage IJ, Essink-Bot M-L, Otto SJ, Draisma G, Bangma CH, Roobol MJ, Schröder FH,, De Koning HJ. Quality-of-Life Effects of Prostate-Specific Antigen Screening. N Engl J Med 2012;367(7):595-605.
  1. Klaveren RJ van, Oudkerk M, Prokop M, Scholten ET, Nackaerts K, Vernhout R, Iersel CA van, Bergh KAM van de, Westeinde SC van ‘t, van der Aalst C, Thunissen E, Xu DM, Wang Y, Zhao Y, Gietema HA, De Hoop B-J, Groen HJM, Bock GH, Van Ooijen P, Weenink C, Verschakelen J, Lammers JWJ, Timens W, Willebrand D, Vink A, Mali WPTM, De Koning HJ. Management of lung nodules detected by Volume CT Scanning. N Eng J Med 2009;361(123):2221-2229.
  1. Koning, HJ de, Meza R, Plevritis SK, Ten Haaf K, Munshi VN, Jeon J, Erdogan SA, Kong CY, Han SS, Van Rosmalen J, Choi SE, Pinsky PF, De Gonzalez AB, Berg CD, Black WC, Tammemagi MC, Hazelton WD, Feuer EJ, and McMahon PM. Benefits and Harms of Computed Tomography Lung Cancer Screening Strategies: A Comparative Modeling Study for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2014;160 (5):311-20.
  1. Louwers ECFM, Korfage IJ, Affourtit MJ, Scheewe DJH, Van De Merwe MH, Vooijs-Moulaert AFSR, Van Den Elzen APM, Jongejan MH, Ruige M, Manaï BHAN, Looman CWN, Bosschaart AN, Teeuw AH, Moll HA, De Koning HJ. Effects of Systematic Screening and Detection of Child Abuse in Emergency Departments. Pediatrics 2012;130(3):457-64.
  1. Saadatmand SM, Tilanus-Linthorst MA, Rutgers EJT, Hoogerbrugge N, Oosterwijk JC, Tollenaar RAEM, Hooning M, Loo CE, Obdeijn IM, Heijnsdijk EAM, De Koning HJ. Cost-Effectiveness of Screening Women with Familial Risk for Breast Cancer with Magnetic Resonance Imaging. Journal of the National Cancer Institute 2013;105(17):1314-21.
  1. Saadatmand S, Geuzinge HA, Rutgers EJT, Mann R, de Roy van Zuidewijn DBW, Zonderland H, Tollenaar RAE, Lobbes MBI, Ausems MGE, van 't Riet M, Hooning MJ, Mares-Engelberts I, Luiten EJT, Heijnsdijk EAM, Verhoef C, Karssemeijer N, Oosterwijk JC, Obdeijn IM, de Koning HJ, Tilanus-Linthorst MMA; FaMRIsc study group. MRI versus mammography for breast cancer screening in women with familial risk (FaMRIsc): a multicentre, randomised, controlled trial. Lancet Oncol. 2019 Aug;20(8):1136-1147. doi: 10.1016/S1470-2045(19)30275-X. Epub 2019 Jun 17.
  1. Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, Kwiatkowski M, Lujan M, Lilja H, Zappa M, Denis LJ, Recker F, Páez A, Määttänen L, Bangma CH, Aus G, Carlsson S, Villers A, Rebillard X, van der Kwast T, Kujala PM, Blijenberg BG, Stenman UH, Huber A, Taari K, Hakama M, Moss SM, De Koning HJ, Auvinen A; ERSPC Investigators. “Prostate-cancer mortality at 11 years of follow-up”. N Engl J Med. 2012 Mar 15;366(11):981-90.
  1. Ten Haaf K, Jeon J, Tammemägi MC, Han SS, Kong CY, Plevritis SK, Feuer EJ, De Koning HJ, Steyerberg EW, Meza R. Risk prediction models for selection of lung cancer screening candidates: A retrospective validation study. PLoS Med. 2017 Apr 4;14(4):e1002277. doi: 10.1371/journal.pmed.1002277. eCollection 2017 Apr.
  1. Ten Haaf K, Bastani M, Cao P, Jeon J, Toumazis I, Han SS, Plevritis SK, Blom EF, Kong CY, Tammemägi MC, Feuer EJ, Meza R, de Koning HJ. A comparative modeling analysis of risk-based lung cancer screening strategies. J Natl Cancer Inst. 2019 Sep 30. pii: djz164. doi: 10.1093/jnci/djz164.


Updated: August 2020