Cancer registration and healthcare access in West Bank, Palestine: A GIS analysis of childhood cancer, 1998–2007

Abstract

In low and middle income countries (LMIC), high‐quality disease registration is difficult to achieve in the setting of inadequate healthcare infrastructure and political or economical instability. In this article, we explore the potential of geographic information systems (GIS) to add value to the understanding of childhood cancer patterns in the West Bank, despite a variety of obstacles to disease registration. All incidence cases of childhood cancers (under the age 15) from 1998 to 2007 were collected from the West Bank Cancer Registry. Temporal, spatial and space–time analyses were performed using the SatScan software developed by Martin Kulldorff and the National Cancer Institute (NCI). The analyses were categorized into the following groups: all childhood cancer, leukemias, acute lymphocytic leukemia, lymphomas, brain and central nervous system (CNS) cancers and remaining cancers (excluding leukemia, lymphoma and CNS tumors). The temporal analysis revealed that cancer registration was more complete from 1998 to 2000 (p = 0.0162), and that leukemia registration was severely deficient from 2003 to 2005 (p = 0.0012). The spatial analysis showed a concentration of cancer in metropolitan districts where referral hospitals are based. Under registration was detected in the northern districts of Jenin and Tulkarm (RR = 0.59, p = 0.0059), more prominent from 2002 to 2005 (RR = 0.33, p = 0.0006). The analysis for high rates found a cluster of lymphoma in town of Dura and its surrounding agricultural villages (RR = 4.10, p = 0.0023). Our study reveals that the application of GIS tools to registry data in LMIC can help to identify geographical patterns in cancer registration and healthcare accessibility, generating priorities for future health research and policy in resource‐limited areas.

Spatial epidemiology of cancer: a review of data sources, methods and risk factors

“…The importance of creating maps that accurately describe disease spatial distribution patterns appeared to be a consensual issue (Kulldorff et al, 2006) though the method used to achieve this was not consensual. Some articles intended to define the best method for some type of analysis for some particular datasets by comparing the results of the application of different spatial analysis methods (Bailony et al, 2011;Biggeri et al, 2009;Chen et al, 2008a;Colonna, 2004;Dasgupta et al, 2014;Goovaerts, 2005Goovaerts, , 2006aHegarty et al, 2010;Huang et al, 2008;Kaldor and Clayton, 1989;Kulldorff et al, 2006;Meliker et al, 2009;Sherman et al, 2014;Sloan et al, 2012;Zhou et al, 2008b). Table 5 shows a classification of some of most common spatial issues covered by research papers, as well as methods used to answer them.…”

“…With respect to cluster analysis, some authors consider it advisable to compare the results obtained by applying more than one method or software (Chen et al, 2008a), as this procedure allows a greater degree of certainty that one cluster corresponds to a real aggregation of cases (Bailony et al, 2011). Other authors go further and advise the comparison of results obtained by applying various methods at various scales in order to detect areas of activity in public health (Mohebbi et al, 2008).…”

“…Individual data Cancer registries Aballay et al (2012), Absalon and Slesak (2011), Al-Ahmadi and Al-Zahrani (2013), Alvarez et al (2009), Bailony et al (2011), Bambhroliya et al (2012, Bristow et al (2014), Buntinx et al (2003), Cassetti et al (2008), Chen et al (2008b, 2011, Chien et al (2013a), Christian et al (2011), Colak et al (2015, Colonna (2004Colonna ( , 2006, Colonna et al (1990), Cramb et al (2011), Dai and Oyana (2008), David et al (2002), DeChello and Sheehan (2007), DeChello et al (2006), Drapeau et al (1995), Elebead et al (2012), Elferink et al (2012), Fairley et al (2008), Fedewa et al (2009), Ferreira et al (2012, Fortunato et al (2011), Gallagher et al (2010, Garcia Martinez et al (2014), Gbary et al (1995), Goodman et al (2010), Xiao (2011, 2012), Guajardo and Oyana (2009), Samociuk (2003, 2013) Godon et al (1991), Goovaerts (2005Goovaerts ( , 2006aGoovaerts ( , 2006b), Hendryx et al (2010), Hosseintabar Marzoni et al (2015, …”

Overview of Cancer Registration Research in the Asian Pacific from 2008-2013

“…In the West Bank spatial analysis showed a concentration of cancer in metropolitan districts where referral hospitals are based, under registration occurring elsewhere (Bailony et al, 2011). Annual rates of childhood leukaemia in Basrah were similar to those in other countries with a trend towards younger children (Alrudainy et al, 2011).…”

Assistencia ao cancer entre criancas e adolescentes: mapeamento dos fluxos origem-destino no Brasil

“…13 Differences in childhood cancer incidence rates between high income countries and the majority of low and middle income countries are related, with lower rates in the latter, suggesting under reporting and under diagnosis of the disease due to insuffi cient access to specialist services. 3,4,16,17,24 This study aimed fl ows of travel between place of residence and health care services by children and adolescents with cancer.…”