Spatial Analysis of Colorectal Cancer Cases in Kuala Lumpur


Background: In Malaysia, data from the Malaysian Health Ministry showed colorectal cancer (CRC) to be thesecond most common type of cancer in 2007-2009, after breast cancer. The same was apparent after looking atmales and females cases separately. In the present study, the Geographic Information System (GIS) was employedto describe the distribution of CRC cases in Kuala Lumpur (KL), Malaysia, according to socio-demographicfactors (age, gender, ethnicity and district). Materials and
Methods: This retrospective review concerned datafor patients diagnosed with colorectal cancer in the years 1995 to 2011 collected from the Wilayah PersekutuanHealth Office, taken from the cancer notification form (NCR-2), and patient medical records from the SurgicalDepartment, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A total of 146 cases were analyzed.All the data collected were analysed using ArcGIS version 10.0 and SPSS version 19.0.
Results: Patients aged 60to 69 years accounted for the highest proportion of cases (34.2%) and males slightly predominated 76 (52.1%),Chinese had the highest number of registered cases at 108 (74.0%) and staging revealed most cases in the 3rdand 4th stages. Kernel density analysis showed more cases are concentrated up in the northern area of Petalingand Kuala Lumpur subdistricts. Spatial global pattern analysis by average nearest neighbour resulted in nearestneighbour ratio of 0.75, with Z-score of -5.59, p value of <0.01 and the z-score of -5.59. Spatial autocorrelation(Moran’s I) showed clustering significant with p<0.01, Z score 3.14 and Moran’s Index of 0.007. When mappingclusters with hotspot analysis (Getis-Ord Gi), hot and cold spots were identified. Hot spot areas fell on thenortheast side of KL.
Conclusions: This study demonstrated significant spatial patterns of cancer incidence inKL. Knowledge about these spatial patterns can provide useful information to policymakers in the planning ofscreening of CRC in the targeted population and improvement of healthcare facilities to provide better treatmentfor CRC patients.