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Professor Diana Sarfati,
Head of Department, Department of Public Health

DiSarfati-web

MBChB, MPH, PhD, FNZCPHM

Head of Department
Professor, Director; Cancer and Chronic Conditions (C3) research group

Contact details 

Tel 64 4 918 6042
Fax 64 4 389 5319
Email diana.sarfati@otago.ac.nz

Research interests and activities 

Professor Diana Sarfati (MBChB, MPH, PhD, FNZCPHM) is a public health physician, cancer epidemiologist and health services researcher. She is Head of the Department of Public Health and the Director of the Cancer and Chronic Conditions (C3) research group at University of Otago, Wellington.

Diana has led a large body of research relating to ethnic disparities in cancer outcomes, particularly those affecting Indigenous peoples. This work has resulted in the identification of key patient and health system factors that influence cancer survival. It has been used extensively by health policy makers, clinicians and other researchers to develop policies and practices that aim to reduce inequities in cancer outcomes.

Her broader research on health services relates to cancer, maternity systems, and services for people with long-term conditions and complex healthcare needs. Her work in screening has included both research and policy elements. She is a former member of the National Screening Advisory Group and the National Bowel Cancer Screening Advisory Committee. She also has research interests in interventions to improve outcomes for those with cancer, type II diabetes and multimorbidity. For more information see C3 research.

Diana is currently a member of the National Cancer Leadership Board (NZ), the Advisory Committee to International Agency for Research on Cancer’s (IARC) Pacific cancer hub, IARC’s international expert group on social inequalities in cancer, the Academic Advisory Committee on the International Cancer Benchmarking Project, and she is currently leading a Lancet Oncology series on cancer in small island developing states. Diana’s primary teaching focus is on post-graduate courses in epidemiology.

Diana is a past member of the National Ethics Advisory Committee, the Bowel Cancer Screening Taskforce, the National Bowel Cancer Working Group, the Board of the Cancer Society (Wellington Division), the Cancer Society Medical and Scientific Assessment Committee (Wellington) and the National Cancer Society Health Promotion Committee.

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Publications

Huang, S., Signal, V., Sarfati, D., Shaw, C., Stanley, J., McGlynn, K., & Gurney, J. (2018). Physical activity and risk of testicular cancer: A systematic review. BMC Cancer, 18, 189. doi: 10.1186/s12885-018-4093-3

Dew, K., Signal, L., Stairmand, J., Simpson, A., & Sarfati, D. (2018). Cancer care decision-making and treatment consent: An observational study of patients’ and clinicians’ rights. Journal of Sociology. Advance online publication. doi: 10.1177/1440783318773880

Gurney, J. K., Stanley, J., & Sarfati, D. (2018). The M3 multimorbidity index outperformed both Charlson and Elixhauser indices when predicting adverse outcomes in people with diabetes. Journal of Clinical Epidemiology, 99, 144-152. doi: 10.1016/j.jclinepi.2018.04.002

Stanley, J., Semper, K., Millar, E., & Sarfati, D. (2018). Epidemiology of multimorbidity in New Zealand: A cross-sectional study using national-level hospital and pharmaceutical data. BMJ Open, 8(5), e021689. doi: 10.1136/bmjopen-2018-021689

Sharples, K., Firth, M., Hinder, V., Hill, A., Jeffery, M., Sarfati, D., … Atmore, C., … Derrett, S., … Keating, J., … Jackson, C., & Findlay, M. (2018). The New Zealand PIPER Project: Colorectal cancer survival according to rurality, ethnicity and socioeconomic deprivation: Results from a retrospective cohort study. New Zealand Medical Journal, 1476(131), 24-39. Retrieved from https://www.nzma.org.nz/journal

Authored Book - Other

Sarfati, D., & Scott, K. (1999). Taking the Pulse: the 1996/97 New Zealand Health Survey. Wellington: Ministry of Health.

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Chapter in Book - Research

Dew, K., Cunningham, C., Davies, C., Tavite, H., Stairmand, J., Sarfati, D., & Signal, L. (2017). Māori-centered research and ethnomethodology: Cancer inequities and research by and for indigenous peoples. In SAGE research methods: Cases part 2. SAGE. doi: 10.4135/9781526409218

Fleming, S. T., Sarfati, D., Kimmick, G., Schoenberg, N., & Cunningham, R. (2016). Impact of comorbidity on cancer screening and diagnosis. In B. Koczwara (Ed.), Cancer and chronic conditions: Addressing the problem of multimorbidity in cancer patients and survivors. (pp. 105-129). Springer. doi: 10.1007/978-981-10-1844-2

Sarfati, D. (2016). How do we measure comorbidity? In B. Koczwara (Ed.), Cancer and chronic conditions: Addressing the problem of multimorbidity in cancer patients and survivors. (pp. 35-70). Springer. doi: 10.1007/978-981-10-1844-2

Sarfati, D., & Gurney, J. (2016). What is comorbidity? In B. Koczwara (Ed.), Cancer and chronic conditions: Addressing the problem of multimorbidity in cancer patients and survivors. (pp. 1-33). Springer. doi: 10.1007/978-981-10-1844-2

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Journal - Research Article

Huang, S., Signal, V., Sarfati, D., Shaw, C., Stanley, J., McGlynn, K., & Gurney, J. (2018). Physical activity and risk of testicular cancer: A systematic review. BMC Cancer, 18, 189. doi: 10.1186/s12885-018-4093-3

Stanley, J., Semper, K., Millar, E., & Sarfati, D. (2018). Epidemiology of multimorbidity in New Zealand: A cross-sectional study using national-level hospital and pharmaceutical data. BMJ Open, 8(5), e021689. doi: 10.1136/bmjopen-2018-021689

Sharples, K., Firth, M., Hinder, V., Hill, A., Jeffery, M., Sarfati, D., … Atmore, C., … Derrett, S., … Keating, J., … Jackson, C., & Findlay, M. (2018). The New Zealand PIPER Project: Colorectal cancer survival according to rurality, ethnicity and socioeconomic deprivation: Results from a retrospective cohort study. New Zealand Medical Journal, 1476(131), 24-39. Retrieved from https://www.nzma.org.nz/journal

Gurney, J. K., Stanley, J., & Sarfati, D. (2018). The M3 multimorbidity index outperformed both Charlson and Elixhauser indices when predicting adverse outcomes in people with diabetes. Journal of Clinical Epidemiology, 99, 144-152. doi: 10.1016/j.jclinepi.2018.04.002

Dew, K., Signal, L., Stairmand, J., Simpson, A., & Sarfati, D. (2018). Cancer care decision-making and treatment consent: An observational study of patients’ and clinicians’ rights. Journal of Sociology. Advance online publication. doi: 10.1177/1440783318773880

Gurney, J., Stanley, J., Rumball-Smith, J., York, S., & Sarfati, D. (2018). Postoperative death after lower-limb amputation in a national prevalent cohort of patients with diabetes. Diabetes Care. Advance online publication. doi: 10.2337/dc17-2557

Stairmand, J., Gurney, J., Stanley, J., Millar, E., Davies, C., Semper, K., Dowell, A., Mangin, D., Lawrenson, R., & Sarfati, D. (2018). The impact of multimorbidity on people's lives: A cross-sectional survey. New Zealand Medical Journal, 131(1477), 78-90. Retrieved from https://www.nzma.org.nz/journal

Millar, E., Stanley, J., Gurney, J., Stairmand, J., Davies, C., Semper, K., Dowell, A., … Sarfati, D. (2018). Effect of multimorbidity on health service utilisation and health care experiences. Journal of Primary Health Care, 10(1), 44-53. doi: 10.1071/HC17074

Diaz, A., Baade, P. D., Valery, P. C., Whop, L. J., Moore, S. P., Cunningham, J., … Sarfati, D., … Condon, J. R. (2018). Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012). PLoS ONE, 13(5), e0196764. doi: 10.1371/journal.pone.0196764

Tin Tin, S., Mark Elwood, J., Brown, C., Sarfati, D., Campbell, I., Scott, N., … Lawrenson, R. (2018). Ethnic disparities in breast cancer survival in New Zealand: Which factors contribute? BMC Cancer, 18, 58. doi: 10.1186/s12885-017-3797-0

Lew, J.-B., St John, D. J. B., Macrae, F. A., Emery, J. D., Ee, H. C., Jenkins, M. A., … Sarfati, D., … Canfell, K. (2018). Evaluation of the benefits, harms and cost-effectiveness of potential alternatives to iFOBT testing for colorectal cancer screening in Australia. International Journal of Cancer. Advance online publication. doi: 10.1002/ijc.31314

Pilleron, S., Sarfati, D., Janssen-Heijnen, M., Vignat, J., Ferlay, J., Bray, F., & Soerjomataram, I. (2018). Global cancer incidence in older adults, 2012 and 2035: A population-based study. International Journal of Cancer. Advance online publication. doi: 10.1002/ijc.31664

Lawrenson, R., Lao, C., Campbell, I., Harvey, V., Seneviratne, S., Elwood, M., Sarfati, D., & Kuper-Hommel, M. (2018). The impact of different tumour subtypes on management and survival of New Zealand women with Stage I-III breast cancer. New Zealand Medical Journal, 131(1475), 51-60. Retrieved from https://www.nzma.org.nz/journal

Signal, L., Semper, K., Stairmand, J., Davies, C., Millar, E., Dowell, T., … Mangin, D., & Sarfati, D. (2017). A walking stick in one hand and a chainsaw in the other: Patients’ perspectives of living with multimorbidity. New Zealand Medical Journal, 130(1455), 65-76. Retrieved from https://www.nzma.org.nz/journal

Gurney, J. K., Kersting, U. G., Rosenbaum, D., Dissanayake, A., York, S., Grech, R., … Sarfati, D. (2017). Pedobarography as a clinical tool in the management of diabetic feet in New Zealand: A feasibility study. Journal of Foot & Ankle Research, 10, 24. doi: 10.1186/s13047-017-0205-6

O'Brien, I., Signal, L., & Sarfati, D. (2017). Wide-ranging impacts reported by NZ cancer survivors: Is supporting cancer survivor resilience a health sector role? Supportive Care in Cancer. Advance online publication. doi: 10.1007/s00520-017-3943-x

Gurney, J., Richiardi, L., McGlynn, K. A., Signal, V., & Sarfati, D. (2017). Analgesia use during pregnancy and risk of cryptorchidism: A systematic review and meta-analysis. Human Reproduction, 32(5), 1118-1129. doi: 10.1093/humrep/dex047

Gurney, J. K., Stanley, J., York, S., Rosenbaum, D., & Sarfati, D. (2017). Risk of lower limb amputation in a national prevalent cohort of patients with diabetes. Diabetologia. Advance online publication. doi: 10.1007/s00125-017-4488-8

McLeod, M., Kvizhinadze, G., Boyd, M., Barendregt, J., Sarfati, D., Wilson, N., & Blakely, T. (2017). Colorectal cancer screening: How health gains and cost-effectiveness vary by ethnic group, the impact on health inequalities, and the optimal age range to screen. Cancer Epidemiology, Biomarkers & Prevention, 26(9), 1391-1400. doi: 10.1158/1055-9965.epi-17-0150

Lawrenson, R., Lao, C., Campbell, I., Harvey, V., Seneviratne, S., Edwards, M., … Sarfati, D., & Kuper-Hommel, M. (2017). Treatment and survival disparities by ethnicity in New Zealand women with stage I-III breast cancer tumour subtypes. Cancer Causes & Control. Advance online publication. doi: 10.1007/s10552-017-0969-9

Stanley, J., & Sarfati, D. (2017). The new measuring multimorbidity index predicted mortality better than Charlson and Elixhauser indices amongst the general population. Journal of Clinical Epidemiology, 92, 99-110. doi: 10.1016/j.jclinepi.2017.08.005

Ginsburg, O., Badwe, R., Boyle, P., Derricks, G., Dare, A., Evans, T., … Sarfati, D., … Sullivan, R. (2017). Changing global policy to deliver safe, equitable, and affordable care for women's cancers. Lancet, 389(10071), 871-880. doi: 10.1016/s0140-6736(16)31393-9

Sarfati, D., Gurney, J., Lim, B. T., Bagheri, N., Simpson, A., Koea, J., & Dennett, E. (2016). Identifying important comorbidity among cancer populations using administrative data: Prevalence and impact on survival. Asia-Pacific Journal of Clinical Oncology, 12(1), e47-e56. doi: 10.1111/ajco.12130

Gurney, J. K., Stanley, J., Shaw, C., & Sarfati, D. (2016). Ethnic patterns of hypospadias in New Zealand do not resemble those observed for cryptorchidism and testicular cancer: Evidence of differential aetiology? Andrology, 4(1), 82-86. doi: 10.1111/andr.12121

Seneviratne, S., Lawrenson, R., Harvey, V., Ramsaroop, R., Elwood, M., Scott, N., Sarfati, D., & Campbell, I. (2016). Stage of breast cancer at diagnosis in New Zealand: Impacts of socio-demographic factors, breast cancer screening and biology. BMC Cancer, 16, 129. doi: 10.1186/s12885-016-2177-5

Lawrenson, R., Lao, C., Elwood, M., Brown, C., Sarfati, D., & Campbell, I. (2016). Urban rural differences in breast cancer in New Zealand. International Journal of Environmental Research & Public Health, 13(10), 1000. doi: 10.3390/ijerph13101000

Wernham, E., Gurney, J., Stanley, J., Ellison-Loschmann, L., & Sarfati, D. (2016). A comparison of midwife-led and medical-led models of care and their relationship to adverse fetal and neonatal outcomes: A retrospective cohort study in New Zealand. PLoS Medicine, 13(9), e1002134. doi: 10.1371/journal.pmed.1002134

Firth, M. J., Sharples, K. J., Hinder, V. A., Macapagal, J., Sarfati, D., Derrett, S. L., … Atmore, C., Keating, J. P., Jeffery, M., … Jackson, C. G. C. A., & Findlay, M. P. N. (2016). Methods of a national colorectal cancer cohort study: The PIPER Project. New Zealand Medical Journal, 129(1440), 25-36. Retrieved from https://www.nzma.org.nz/journal

Gurney, J. K., Stanley, J., Baker, M. G., Wilson, N. J., & Sarfati, D. (2016). Estimating the risk of acute rheumatic fever in New Zealand by age, ethnicity and deprivation. Epidemiology & Infection, 144(14), 3058-3067. doi: 10.1017/s0950268816001291

Teng, A. M., Atkinson, J., Disney, G., Wilson, N., Sarfati, D., McLeod, M., & Blakely, T. (2016). Ethnic inequalities in cancer incidence and mortality: Census-linked cohort studies with 87 million years of person-time follow-up. BMC Cancer, 16, 755. doi: 10.1186/s12885-016-2781-4

Gurney, J., Chong, A., Culliford-Semmens, N., Tilton, E., Wilson, N. J., & Sarfati, D. (2016). The benefits and harms of rheumatic heart disease screening from the perspective of the screened population. International Journal of Cardiology, 221, 734-740. doi: 10.1016/j.ijcard.2016.07.025

Sarfati, D., Koczwara, B., & Jackson, C. (2016). The impact of comorbidity on cancer and its treatment. CA: A Cancer Journal for Clinicians, 66(4), 337-350. doi: 10.3322/caac.21342

Sheerin, I., Green, T., Sarfati, D., & Cox, B. (2015). Projected costs of colorectal cancer treatment in New Zealand in the absence of population screening. New Zealand Medical Journal, 128(1408). Retrieved from https://www.nzma.org.nz/journal

Gurney, J. K., Sarfati, D., & Stanley, J. (2015). Obscure etiology, unusual disparity: The epidemiology of testicular cancer in New Zealand. Cancer Causes & Control, 26(4), 561-569. doi: 10.1007/s10552-015-0533-4

Blakely, T., Collinson, L., Kvizhinadze, G., Nair, N., Foster, R., Dennett, E., & Sarfati, D. (2015). Cancer care coordinators in stage III colon cancer: A cost-utility analysis. BMC Health Services Research, 15, 306. doi: 10.1186/s12913-015-0970-5

Signal, V., Sarfati, D., Cunningham, R., Gurney, J., Koea, J., & Ellison-Loschmann, L. (2015). Indigenous inequities in the presentation and management of stomach cancer in New Zealand: A country with universal health care coverage. Gastric Cancer, 18(3), 571-579. doi: 10.1007/s10120-014-0410-y

Stairmand, J., Signal, L., Sarfati, D., Jackson, C., Batten, L., Holdaway, M., & Cunningham, C. (2015). Consideration of comorbidity in treatment decision making in multidisciplinary cancer team meetings: A systematic review. Annals of Oncology, 26, 1325-1332. doi: 10.1093/annonc/mdv025

McDonald, A. M., Sarfati, D., Baker, M. G., & Blakely, T. (2015). Trends in Helicobacter pylori infection among Māori, Pacific, and European birth cohorts in New Zealand. Helicobacter, 20(2), 139-145. doi: 10.1111/hel.12186

Cunningham, R., Sarfati, D., Stanley, J., Peterson, D., & Collings, S. (2015). Cancer survival in the context of mental illness: A national cohort study. General Hospital Psychiatry, 37, 501-506. doi: 10.1016/j.genhosppsych.2015.06.003

Gurney, J., Sarfati, D., & Stanley, J. (2015). The impact of patient comorbidity on cancer stage at diagnosis. British Journal of Cancer, 113, 1375-1380. doi: 10.1038/bjc.2015.355

Dew, K., Signal, L., Davies, C., Tavite, H., Hooper, C., Sarfati, D., Stairmand, J., & Cunningham, C. (2015). Dissonant roles: The experience of Māori in cancer care. Social Science & Medicine, 138, 144-151. doi: 10.1016/j.socscimed.2015.06.008

Gurney, J., Shaw, C., Stanley, J., Signal, V., & Sarfati, D. (2015). Cannabis exposure and risk of testicular cancer: A systematic review and meta-analysis. BMC Cancer, 15, 897. doi: 10.1186/s12885-015-1905-6

Dew, K., Stubbe, M., Signal, L., Stairmand, J., Dennett, E., Koea, J., Simpson, A., Sarfati, D., … Holdaway, M. (2015). Cancer care decision making in multidisciplinary meetings. Qualitative Health Research, 25(3), 397-407. doi: 10.1177/1049732314553010

Sarfati, D., Gurney, J., Stanley, J., Salmond, C., Crampton, P., Dennett, E., … Pearce, N. (2014). Cancer-specific administrative data—based comorbidity indices provided valid alternative to Charlson and National Cancer Institute Indices. Journal of Clinical Epidemiology, 67(5), 586-595. doi: 10.1016/j.jclinepi.2013.11.012

Cunningham, R., Peterson, D., Sarfati, D., Stanley, J., & Collings, S. (2014). Premature mortality in adults using New Zealand psychiatric services. New Zealand Medical Journal, 127(1394). Retrieved from http://www.nzma.org.nz/journal

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