Optimizing allocation of colorectal cancer screening hospitals in Shanghai: a geospatial analysis

Submitted: 14 September 2022
Accepted: 21 March 2023
Published: 3 July 2023
Abstract Views: 1174
PDF: 566
Supplementary Materials: 54
HTML: 17
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Screening programmes are important for early diagnosis and treatment of colorectal cancer (CRC) but they are not equally efficient in all locations. Depending on which hospital people belong to, they often are not willing to follow up even after a positive result, resulting in a lower-than-expected overall detection rate. Improved allocation of health resources would increase the program’s efficiency and assist hospital accessibility. A target population exceeding 70,000 people and 18 local hospitals were included in the investigation of an optimization plan based on a locationallocation model. We calculated the hospital service areas and the accessibility for people in communities to CRC-screening hospitals using the Huff Model and the Two-Step Floating Catchment Area (2SFCA) approach. We found that only 28.2% of the residents with initially a positive screening result had chosen followup with colonoscopy and significant geographical differences in spatial accessibility to healthcare services indeed exist. The lowest accessibility was found in the Southeast, including the Zhangjiang, Jichang and Laogang communities with the best accessibility mainly distributed near the city centre of Lujiazui; the latter also had relatively a high level of what is called “ineffective screening” as it represents wasteful resource allocation. It is recommended that Hudong Hospital should be chosen instead of Punan Hospital as the optimization, which can improve the service population of each hospital and the populations served per colonoscope. Based on our results, changes in hospital configuration in colorectal cancer screening programme are needed to achieve adequate population coverage and equitable facility accessibility. Planning of medical services should be based on the spatial distribution trends of the population served.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Baidu Maps. Available from: https://map.baidu.com
Benard F, Barkun AN, Martel M, von Renteln D, 2018. Systematic review of colorectal cancer screening guidelines for average-risk adults: Summarizing the current global recommendations. World J Gastroenterol 24:124-38. DOI: https://doi.org/10.3748/wjg.v24.i1.124
Chiu HM, Hsu WF, Chang LC, Wu MH, 2017. Colorectal Cancer Screening in Asia. Curr Gastroenterol Rep 19:47. DOI: https://doi.org/10.1007/s11894-017-0587-4
ESRI, 2021. Location-allocation analysis. Accessed 15 January 2023. Available at: https://desktop.arcgis.com/en/arcmap/latest/extensions/network-analyst/location-allocation.htm.
Gheysariyeha F, Rahimi F, Tabesh E, Hemami MR, Adibi P, Rezayatmand R, 2022. Cost‐effectiveness of colorectal cancer screening strategies: A systematic review. Eur J Cancer Care 31:e13673. DOI: https://doi.org/10.1111/ecc.13673
Gong Y, Peng P, Bao P, Zhong W, Shi Y, Gu K, Zheng Y, Wu C, Cai S, Xu Y, Sheng J, Wu F, 2018. The Implementation and First‐Round Results of a Community‐Based Colorectal Cancer Screening Program in Shanghai, China. Oncologist 23:928-35. DOI: https://doi.org/10.1634/theoncologist.2017-0451
Gu X, Zhang L, Tao S, Xie B, 2019. Spatial accessibility to healthcare services in metropolitan suburbs: the case of Qingpu, Shanghai. Int J Environ Res Public Health 16:1-16. DOI: https://doi.org/10.3390/ijerph16020225
Hewitson P, Glasziou P, Watson E, Towler B, Irwig L, 2008. Cochrane Systematic Review of Colorectal Cancer Screening Using the Fecal Occult Blood Test (Hemoccult): An Update. Am J Gastroenterol 103:1541-9. DOI: https://doi.org/10.1111/j.1572-0241.2008.01875.x
Huff DL, 1963. A Probabilistic Analysis of Shopping Center Trade Areas. Land Econ 39:81-90. DOI: https://doi.org/10.2307/3144521
International Agnecy fro Reasearch on Cancer (IARC). Cancer today. Avaiable from: https://gco.iarc.fr/today/home
Issa IA, Noureddine M, 2017. Colorectal cancer screening: An updated review of the available options. World J Gastroenterol 23:5086-96. DOI: https://doi.org/10.3748/wjg.v23.i28.5086
Jia P, Xierali IM, Fahui W, 2015. Evaluating and re-demarcating the Hospital Service Areas in Florida. Appl Geogr 60:248-53. DOI: https://doi.org/10.1016/j.apgeog.2014.10.008
Kirby RS, Delmelle E, Eberth JM, 2017. Advances in spatial epidemiology and geographic information systems. Ann Epidemiol 27:1-9. DOI: https://doi.org/10.1016/j.annepidem.2016.12.001
Li X, Qian M, Zhao G, Yang C, Bao P, Chen Y, Zhou X, Yan B, Wang Y, Zhang J, Sun Q, 2019. The performance of a community-based colorectal cancer screening program: Evidence from Shanghai Pudong New Area, China. Prev Med 118:243-50. DOI: https://doi.org/10.1016/j.ypmed.2018.11.002
Li XP, Cao GW, Sun Q, Yang C, Yan B, Zhang MY, Fu YF, Yang LM, 2012. Cancer incidence and patient survival rates among residents in the Pudong New Area of Shanghai between 2002 and 2006. Chin J Cancer 2013;32:512-9. DOI: https://doi.org/10.5732/cjc.012.10200
Luo W, Wang F, 2016. Measures of Spatial Accessibility to Health Care in a GIS Environment: Synthesis and a Case Study in the Chicago Region. Environ Plann B Plann Des 30:865-84. DOI: https://doi.org/10.1068/b29120
Mandal R, Basu P, 2018. Cancer screening and early diagnosis in low and middle income countries: Current situation and future perspectives. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 61:1505-12. DOI: https://doi.org/10.1007/s00103-018-2833-9
Navarro M, Nicolas A, Ferrandez A, Lanas A, 2017. Colorectal cancer population screening programs worldwide in 2016: An update. World J Gastroenterol 23:3632-42. DOI: https://doi.org/10.3748/wjg.v23.i20.3632
OpenStreetMap. Available from: https://www.openstreetmap.org
Polo G, Acosta CM, Ferreira F, Dias RA, 2015. Location-allocation and accessibility models for improving the spatial planning of public health services. PLoS One 10:e0119190. DOI: https://doi.org/10.1371/journal.pone.0119190
Radke J, Mu L, 2000. Spatial decompositions, modeling and mapping service regions to predict access to social programs. Ann GIS 6:105-12. DOI: https://doi.org/10.1080/10824000009480538
Rahman S, Smith DK, 2000. Use of location-allocation models in health service development planning in developing nations. Eur J Oper Res 123:437-452. DOI: https://doi.org/10.1016/S0377-2217(99)00289-1
Schreuders EH, Ruco A, Rabeneck L, Schoen RE, Sung JJ, Young GP, Kuipers EJ, 2015. Colorectal cancer screening: a global overview of existing programmes. Gut 64:1637-49. DOI: https://doi.org/10.1136/gutjnl-2014-309086
Shanghai Surveying and Mapping Institute, 2016. Diagram of the administrative division of Pudong New Distric. Accessed 15 January 2023. Available at: https://www.shsmi.cn/.
Siegel RL, Miller KD, Jemal A, 2018. Cancer statistics, 2018. CA Cancer J Clin 68:7-30. DOI: https://doi.org/10.3322/caac.21442
van Hees F, Saini SD, Lansdorp-Vogelaar I, Vijan S, Meester RG, de Koning HJ, Zauber AG, van Ballegooijen M, 2015. Personalizing colonoscopy screening for elderly individuals based on screening history, cancer risk, and comorbidity status could increase cost effectiveness. Gastroenterology 149:1425-37. DOI: https://doi.org/10.1053/j.gastro.2015.07.042
Wang F, 2014. Quantitative Methods and Socio-Economic Applications in GIS (2nd ed.), CRC Press, 333 pp. DOI: https://doi.org/10.1201/b17967
Wan N, Zhan FB, Zou B, Chow E, 2012. A relative spatial access assessment approach for analyzing potential spatial access to colorectal cancer services in Texas. Appl Geogr 32:291-9. DOI: https://doi.org/10.1016/j.apgeog.2011.05.001

How to Cite

Huang, J., Chen, Y., Liu, G., Tu, W., Bergquist, R., P. Ward, M., Zhang, J., Xiao, S., Hong, J., Zhao, Z., Li, X., & Zhang, Z. (2023). Optimizing allocation of colorectal cancer screening hospitals in Shanghai: a geospatial analysis. Geospatial Health, 18(2). https://doi.org/10.4081/gh.2023.1152