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.
Publications
Gurney, J. K., Stanley, J., York, S., & Sarfati, D. (2019). Regional variation in the risk of lower-limb amputation among patients with diabetes in New Zealand. ANZ Journal of Surgery. Advance online publication. doi: 10.1111/ans.15079
Lawrenson, R., Lao, C., Jacobson, G., Seneviratne, S., Scott, N., Sarfati, D., … Campbell, I. (2019). Outcomes in different ethnic groups of New Zealand patients with screen-detected vs. non-screen-detected breast cancer. Journal of Medical Screening. Advance online publication. doi: 10.1177/0969141319844801
Sarfati, D., Jackson, C. G. C. A., Macfarlane, S., Bissett, I., Robson, B., Gurney, J., Kemp, R., … McMenamin, J. (2019). Cancer Care at a Crossroads: Time to make a choice. New Zealand Medical Journal, 132(1493), 6-11. Retrieved from https://www.nzma.org.nz/journal
Sarfati, D. (2019, January-February). Trends and disparities in cancer in Aotearoa New Zealand. Verbal presentation at the Cancer Care at a Crossroads Conference, Wellington, New Zealand.
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
Authored Book - Other
Sarfati, D., & Scott, K. (1999). Taking the Pulse: the 1996/97 New Zealand Health Survey. Wellington: Ministry of Health.
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., & 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
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
Journal - Research Article
Gurney, J. K., Stanley, J., York, S., & Sarfati, D. (2019). Regional variation in the risk of lower-limb amputation among patients with diabetes in New Zealand. ANZ Journal of Surgery. Advance online publication. doi: 10.1111/ans.15079
Lawrenson, R., Lao, C., Jacobson, G., Seneviratne, S., Scott, N., Sarfati, D., … Campbell, I. (2019). Outcomes in different ethnic groups of New Zealand patients with screen-detected vs. non-screen-detected breast cancer. Journal of Medical Screening. Advance online publication. doi: 10.1177/0969141319844801
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
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
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
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
Millar, E., Gurney, J., Stanley, J., Stairmand, J., Davies, C., Semper, K., Dowell, A., … Sarfati, D. (2018). Pill for this and a pill for that: A cross-sectional survey of use and understanding of medication among adults with multimorbidity. Australasian Journal on Ageing. Advance online publication. doi: 10.1111/ajag.12606
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
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
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
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, 143(2), 269-282. doi: 10.1002/ijc.31314
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
O'Brien, I., Signal, L., & Sarfati, D. (2018). Wide-ranging impacts reported by NZ cancer survivors: Is supporting cancer survivor resilience a health sector role? Supportive Care in Cancer, 26(4), 1207-1213. doi: 10.1007/s00520-017-3943-x
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
Gurney, J. K., Stanley, J., York, S., Rosenbaum, D., & Sarfati, D. (2018). Risk of lower limb amputation in a national prevalent cohort of patients with diabetes. Diabetologia, 61(3), 626-635. doi: 10.1007/s00125-017-4488-8
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
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
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, 28(2), 1417-1427. doi: 10.1007/s10552-017-0969-9
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
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
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
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
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
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
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
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
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
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
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
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
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., 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
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
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
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
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
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
