อุบัติการณ์และการวิเคราะห์เชิงพื้นที่มะเร็งตับและท่อน้ำดี จังหวัดกาฬสินธุ์

Peeraluk Samranruen; Supot Kamsa-ard; Oraya  Sahat

Authors

Peeraluk Samranruen Master of Public Health student in Epidemiology, Faculty of Public Health, Khon Kaen University
Supot Kamsa-ard Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University
Oraya Sahat Tha Uthen District Public Health Office, Nakhon Phanom

Keywords:

Incidence, Liver and Bile Duct Cancer, Spatial Analysis

Abstract

Background and Objectives: The incidence of liver and bile duct cancer has been steadily increasing. The application of Geographic Information Systems (GIS) to analyze spatial factors offers a promising approach for developing targeted prevention strategies. This study aimed to investigate the spatial determinants and the incidence of liver and bile duct cancer in Kalasin Province, Thailand. Methods: Analysis retrospective cohort study was conducted among patients diagnosed with liver and bile duct cancer residing in Kalasin Province. Data were collected from Kalasin Hospital, covering 1,060 patients (135 sub-district) between January 1, 2019, and December 31, 2023. Factors examined included demographic characteristics, climatic conditions, and environmental context. Spatial relationships between these factors and cancer incidence were analyzed using Getis-Ord Gi*, Global Moran’s I, and Anselin Local Moran’s I (LISA). Incidence rates were reported with 95% confidence intervals (95%CI).

Results: The overall incidence rate of liver and bile duct cancer in Kalasin Province during the study period was 16.32 per 100,000 person-years (95% CI: 15.32–17.32). Males had a significantly higher incidence (24.0 per 100,000; 95% CI: 22.24–25.74) than females (9.35 per 100,000; 95% CI: 8.29–10.40). The highest age-standardized incidence rates (ASRs) among males were observed in Tha Khantho Subdistrict (ASR = 138.44; 95% CI: 18.29–258.61), followed by Nong Saen (ASR=106.84; 95% CI: 4.63–209.04), and Yot Kaeng (ASR=97.58; 95% CI: 14.50–180.68). Among females, the highest ASRs were recorded in Yot Kaeng (ASR=58.92; 95% CI: 4.58–113.24), Um Mao (ASR=57.5; 95% CI: 24.90–90.09), and Dong Ling (ASR=43.86; 95% CI: 0.62–87.12). The Getis-Ord Gi* analysis identified significant high clustering areas of liver and bile duct cancer incidence in Kalasin Province, indicating that these subdistricts had significantly higher rates compared to their surroundings. High-risk clusters were observed in Chaotha, Namon, Lup, Lampan, Ummao, Don Sombun, Klang Muen, Najan, Nong Krungsi, Khok Khruea, Nong Waeng, Lam Huai Lua, and Dong Phayung. Moran’s I and LISA analyses indicated that distance from water sources was significantly associated with cancer incidence (p = 0.047). A positive spatial autocorrelation and clustering (Moran’s I=0.027) LISA identified High-High clusters in Kut Pla Khao, Khum Kao, and Sa-at Chaiyasi subdistricts.

Conclusion: This study found that distant from water sources was linked to higher liver and bile duct cancer incidence. The overall incidence rate is lower than the national average. This lower rate may be due to differences in how comprehensively cancer cases are reported nationwide.

These findings can help guide targeted surveillance and screening programs in high-risk areas, especially those near water sources. The study also recommends establishing mobile health services to improve access to care in remote or high-incidence communities. Such measures will support more effective proactive public health efforts.

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