Out-patient visits for gastrointestinal cancer at a quaternary South African hospital-trends and geospatial distribution

BACKGROUND: This study sought to determine trends in out-patient visits for gastrointestinal cancer (GC) at a quaternary hospital in KwaZulu-Natal (KZN), South Africa; and identify geographical regions which contribute most to GC-related out-patient clinic utilization at this hospital. METHOD: Data for GC-related outpatient visits over an 11-year period was obtained from the hospital's administrative database. Trends were analyzed using simple regression and trend line analyses. Patient residential postal codes from the administrative database were used to determine the geospatial distribution of complex GC in KZN. RESULTS: Strong increasing trends in GC-related out-patient visits were noted for age >65 years old (R(2)=0.8014), male (R(2)=0.7020), female (R(2)=0.7292), lower GC (R(2)=0.7094), and rural residence (R(2)=0.7008). Moderate increasing trends in GC-related out-patient visits were noted for age ≤65 years old (R(2)=0.6556), upper GC (R(2)=0.6498), and urban residence (R(2)=0.6988). The magnitude at which the number of out-patient visits increased was greater for urban residence when compared with rural residence (p=0.006). Urban centers and some regions along the North and South coast of KZN contributed the most toward GC-related out-patient visits. CONCLUSION: Out-patient visits for complex GC in KZN are increasing. Several regions have been identified for anti-cancer interventions and decentralized out-patient services.