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.