Abstract
Introduction: The rising trend of colorectal cancer (CRC) incidence in both elderly and young age groups has drawn attention globally. Despite multiple risk factors linked with colorectal cancer (CRC) being identified at individual-level, the geographical variation may suggest the role of area-level determinants. Therefore, the study aimed to identify the spatial pattern distribution of CRC incidence at neighbourhood level in Malaysia.
Method: Newly diagnosed CRC cases between 2012 and 2016 were retrieved from the National Cancer Registry. Residential addresses for each case were geocoded for coordinates. Clustering analysis was performed to examine spatial dependence. Data on socio-demographic characteristics of each state were included and compared that incorporate the clusters.
Result: Out of the 18 405 CRC cases analysed, predominantly male (56%), highest among 60-69 years group (30.3%) with more than half presented at stage 3 and 4 (71.3%). The spatial statistics confirmed the presence of clusters in the states of Kedah, Penang, Perak, Selangor, Kuala Lumpur, Melaka, Johor Bharu, Kelantan and Sarawak. Spatial autocorrelation showed significant clustering pattern (Moran 's Index of 0.244, p< 0.01, Z score >2.58). CRC clusters in the states of Penang, Selangor, Kuala Lumpur, Melaka, Johor Bharu, and Sarawak were linked to big cities in the urban areas while the clusters in Kedah, Perak and Kelantan were located in the semi-rural areas. The urban cluster is characterized by highly dense population, driven by the industrialization economic background. Meanwhile, the poverty level is relatively higher in the semi-rural areas (10-12%) where agricultural is the main contributor. Conclusion: The presence of significant high clusters in urban and semi-rural areas implies the potential influence of ecological determinants at the neighborhood level. Identification of such factors provides insights for policymakers in the context of healthy settings and resource allocation.
Links
- https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-107.pdf
- https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed1909[...]
BibTeX (Download)
@proceedings{APCPH2022-P-107,
title = {Spatial clustering of Colorectal Cancer incidence in Malaysia},
author = {Azmawati Mohammed Nawi and Sharifah Saffinas Syed Soffian and Rozita Hod and Khairul Nizam Abdul Maulud and Ahmad Tarmizi Mohd Azmi and Mohd Hazrin Hasim@Hashim and Huan-Keat Chan and Muhammad Radzi Abu Hassan},
url = {https://apcph.cphm.my/wp-content/uploads/2022/07/APCPH2022-P-107.pdf
https://apcph.cphm.my/wp-content/uploads/wpforms/1176-1e04940bb5d885bf8711ed19095a89ed/Final-Poster-APACPH-1-b5bb39d18f28faa6bfdfb79540da4ca2.pdf},
year = {2022},
date = {2022-08-02},
urldate = {2022-08-02},
issue = {7},
abstract = {Introduction: The rising trend of colorectal cancer (CRC) incidence in both elderly and young age groups has drawn attention globally. Despite multiple risk factors linked with colorectal cancer (CRC) being identified at individual-level, the geographical variation may suggest the role of area-level determinants. Therefore, the study aimed to identify the spatial pattern distribution of CRC incidence at neighbourhood level in Malaysia.
Method: Newly diagnosed CRC cases between 2012 and 2016 were retrieved from the National Cancer Registry. Residential addresses for each case were geocoded for coordinates. Clustering analysis was performed to examine spatial dependence. Data on socio-demographic characteristics of each state were included and compared that incorporate the clusters.
Result: Out of the 18 405 CRC cases analysed, predominantly male (56%), highest among 60-69 years group (30.3%) with more than half presented at stage 3 and 4 (71.3%). The spatial statistics confirmed the presence of clusters in the states of Kedah, Penang, Perak, Selangor, Kuala Lumpur, Melaka, Johor Bharu, Kelantan and Sarawak. Spatial autocorrelation showed significant clustering pattern (Moran 's Index of 0.244, p\< 0.01, Z score \>2.58). CRC clusters in the states of Penang, Selangor, Kuala Lumpur, Melaka, Johor Bharu, and Sarawak were linked to big cities in the urban areas while the clusters in Kedah, Perak and Kelantan were located in the semi-rural areas. The urban cluster is characterized by highly dense population, driven by the industrialization economic background. Meanwhile, the poverty level is relatively higher in the semi-rural areas (10-12%) where agricultural is the main contributor. Conclusion: The presence of significant high clusters in urban and semi-rural areas implies the potential influence of ecological determinants at the neighborhood level. Identification of such factors provides insights for policymakers in the context of healthy settings and resource allocation.},
howpublished = {published online at https://apcph.cphm.my},
note = {Type: POSTER PRESENTATION; Organisation: Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Earth Observatory Center, Institute of Climate Change, Universiti Kebangsaan Malaysia, Bangi, Malaysia; Insitute for Public Health, National Institute of Health, Bandar Setia Alam, Shah Alam, Malaysia; Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar, Malaysia},
keywords = {colorectal cancer, ecology, geographical variation, spatial cluster},
pubstate = {published},
tppubtype = {proceedings}
}