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Research |
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Estimating and Understanding Social and Biological Factors Contributing to the Burden of Disease due to Breast Cancer in Southeast Asia |
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Listen to what the team aims and expects of their research project
 Mikael Hartman |
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Abstract
Background: Breast cancer incidence rate is on a rise in Asia. Survival of breast cancer has improved in many developed countries during the last decades, attributed to screening and the improvement in diagnostic tools and treatment modalities. However in many developing countries in Asia the survival rates remains relatively poor. The magnitude and the underlying reasons of survival disparities between countries and ethnic groups are uncertain.
Methods: Using a cohort of 4,000 patients diagnosed with breast cancer at the National University Hospital Singapore and the University of Malaya Medical Center, we will estimate and compare 5- and 10-year observed and relative survival between countries and ethnic groups. Differences in distribution of stage, grade, tumor size, lymph nodes involvement and estrogen status will be assessed. Univariate and multivariate regression analysis will be performed to examine those predictive variables of survival separately and in addition to each other.
A qualitative study assessing pre-diagnostic issues will be carried out in three hospitals in study area. 45 patients will be invited to in-depth narrative individual interviews to talk about their understanding and experience of cancer, cancer symptoms, help-seeking trajectories, main motivators and their support networks. The qualitative data will be analyzed in a narrative approach. Cross-examination for similarities and differences in the pattern of presentation and socio-cultural factors influencing delay in seeking medical care between ethnic groups and countries will be performed.
300 newly diagnosed, 300 short term and 300 long term survivors will be invited to assess post-diagnostic issues by answering a questionnaire on delivery of treatment and satisfaction with care. Timeliness and completeness of treatment will be examined. A scoring system will be developed as a quantitative evaluation of satisfaction level. The differences in priorities and satisfaction with care between Singapore and Malaysia and the three ethnic groups will be tested. |
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Team Members |
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Mikael Hartman
Assistant Professor
Department of Epidemiology and Public Health,
National University of Singapore,
Singapore |
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Yip Cheng Har
Professor
Department of Surgery, University Malaya Medical Centre
Malaysia |
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Jennifer N W Lim
Senior Research Fellow
Nuffield Institute for Health, University of Leeds
Leeds, United Kingdom |
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Nur Aishah Mohd Taib
Associate Professor, Consultant Breast Surgeon
Department of Surgery, University Malaya Medical Centre
Malaysia |
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Maznah Dahlui
Lecturer
Department of Social and Preventive Medicine
Malaysia |
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Hong Ga Sze
Head and Senior Consultant
Kandang Kerbau Breast Unit, Kandang Kerbau Woman's and Children's Hospital
Singapore |
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Tar-Ching Aw
Professor and Chairman of Department
Department of Community Medicine, United Arab Emirates University
UAE |
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Helena Marieke Verkooijen
Visiting Associate Professor, Associate Professor
Department of EPH, Yong Loo Lin School of Medicine
Singapore |
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