title: A pilot study of spatial patterns in referrals to a multicentre cancer genetics service.
abstract: OBJECTIVE
  To analyse spatial and temporal patterns in patients referred to a cancer genetics service in order to monitor service utilization and accessibility.
  
  
  METHODS
  Postcodes of patients during a 4-year period were used to examine spatial patterns using a Geographical Information System (GIS). Referral rates were compared visually and statistically to explore yearly variation for administrative areas in Wales.
  
  
  RESULTS
  There has been a four-fold increase in actual referrals to the service over the period of study. The variance between unitary authority referral rates has decreased from the inception of the service from an almost ten-fold difference between lowest and highest in year 1 to less than a three-fold difference in year 4.
  
  
  CONCLUSIONS
  This study shows the potential of GIS to highlight spatial variations in referral rates across Wales. Although the disparity in referral rates has decreased, trends in referral rates are not consistent. Ongoing research will examine those referral and referrer characteristics affecting uptake.
authors.affiliation: Institute of Medical Genetics, University of Wales College of Medicine, Cardiff, UK.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Tempest
authors.forename: Gary
authors.initials: G
authors.lastname: Higgs
authors.forename: Kevin
authors.initials: K
authors.lastname: McDonald
authors.forename: Rachel
authors.initials: R
authors.lastname: Iredale
authors.forename: Tony
authors.initials: T
authors.lastname: Bater
authors.forename: Jonathon
authors.initials: J
authors.lastname: Gray
mesh_terms: D005240:Feasibility Studies; D005817:Genetic Counseling / Q000706:statistics & numerical data*; D020022:Genetic Predisposition to Disease; D006297:Health Services Accessibility; D006801:Humans; D009369:Neoplasms / Q000235:genetics* / Q000628:therapy*; D010865:Pilot Projects; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014852:Wales