This monograph explores the spatial and temporal patterns of first
referrals to the Cancer Genetics Service for Wales (CGSW) in order
to establish what referral patterns exist. CGSW has a patient
population of 10,878 first referrals over the eight year period
1998 to 2006. Nearly 70% are for breast, ovarian, or breast and
ovarian cancer, which helps to explain why more than 90% of all
referred patients are female. Referrals for high risk patients are
more likely to come from secondary care rather than primary care
and vice versa for those at medium risk. There is an inverse
correlation between referrals and deprivation showing that as
deprivation decreases, referrals increase. One temporal trend is an
increase in referrals to the CGSW Swansea centre, and a
corresponding decrease to the other two centres in Cardiff and
Rhyl. These results have not produced any evidence that referral
guidelines influence referrals. This research has identified cancer
genetics as a field that needs to adopt policies aimed at reducing
health inequalities and target resources at meeting unmet needs for
cancer genetics services.
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