A PROPOSAL FOR DISEASE MAPPING IN GENERAL AND CANCER RESEARCH IN PARTICULAR - ASKING QUESTIONS FOR HEALTH GIS IMPLEMENTATION IN SRI LANKA

摘要

As a Public Health Informatics professional and a student of medical geography, one can learn disease mapping methods using GIS. Mapping methods relating to cancer are a sub set of disease mapping methodologies taken for discussion. Breast cancer, prostate cancer and childhood leukemia are some of the cancers being researched in disease mapping. Stan Openshaw's paper on childhood leukemia clusters, the Atlas of Cancer Mortality in the United States (1999), the Long Island breast cancer study and more recently the cancer prevention and cancer control research in Iowa are some projects that have contributed to the refinement of spatial analysis in disease mapping. The data, methods and knowledge base that are required for such a task are readily available in countries like the United States. But the same may not be true for most of the developing countries, including Sri Lanka. This paper has a very simple goal - to design a simple research project to map cancer in Sri Lanka. The project will propose a spatial statistical model for cancer data analysis in Sri Lanka. The proposed investigation begins by defining the research framework for this project. For a non-local (like the author), the problem becomes complex - Where does one begin? Obtaining the necessary datasets could be a starting point. Disease data is typically compiled and available with national or state medical agencies. Additionally, data for specific diseases can be available through a central data repository that is used for national health planning purposes. The national cancer institute at Maharagama in Sri Lanka is one such agency. It is also important to assess usability of the data for spatial analysis. Questions like "Can we use this data to plan a spatial contingency delivery system?" need to be answered. A good study needs to ask such questions. This paper is an attempt to do this. Such studies contribute significantly to planning intervention and prevention programs while satisfying both efficiency and equity questions of health care delivery. In asking these questions the author has two overarching goals. One is to draw attention to some of the good work that is already being carried out in Sri Lanka. The other is to begin more formal and computationally intensive discussions involving spatial analysis in Health GIS. It is possible to organize a cost effective and web based GIS implementation by initiating these discussions.