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
Ramsdale, E. E., Zittel, J., & Sarfati, D. (2020). Comorbidity in aging and cancer. In M. Extermann (Ed.), Geriatric oncology. (pp. 365-393). Cham, Switzerland: Springer. doi: 10.1016/j.jgo.2015.12.002
Signal, V., Jackson, C., Signal, L., Hardie, C., Holst, K., McLaughlin, M., Steele, C., & Sarfati, D. (2020). Improving management of comorbidity in patients with colorectal cancer using comprehensive medical assessment: A pilot study. BMC Cancer, 20, 50. doi: 10.1186/s12885-020-6526-z
Fowler, H., Belot, A., Ellis, L., Maringe, C., Luque-Fernandez, M. A., Njagi, E. N., … Sarfati, D., … Rachet, B. (2020). Comorbidity prevalence among cancer patients: A population-based cohort study of four cancers. BMC Cancer, 20, 2. doi: 10.1186/s12885-019-6472-9
Signal, L. N., Edwards, R., Gage, R., Jackson, N., McKerchar, C., & Sarfati, D. (2020). The state of cancer prevention in Aotearoa New Zealand: Slow progress requires political leadership and investment for health and equity. Journal of Cancer Policy. Advance online publication. doi: 10.1016/j.jcpo.2019.100212
Gurney, J., Stanley, J., Jackson, C., & Sarfati, D. (2020). Stage at diagnosis for Māori cancer patients: Disparities, similarities and data limitations. New Zealand Medical Journal, 133(1508), 43-64. 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.
Chapter in Book - Research
Ramsdale, E. E., Zittel, J., & Sarfati, D. (2020). Comorbidity in aging and cancer. In M. Extermann (Ed.), Geriatric oncology. (pp. 365-393). Cham, Switzerland: Springer. doi: 10.1016/j.jgo.2015.12.002
Teng, A., Blakely, T., & Sarfati, D. (2019). Changing social inequalities in cancer mortality: The value of linking census and health data. In S. Vaccarella, J. Lortet-Tieulent, R. Saracci, D. I. Conway, K. Straif & C. P. Wild (Eds.), Reducing social inequalities in cancer: Evidence and priorities for research [IARC Scientific Publication No. 168]. (pp. 25-27). Lyon, France: international Agency for Research on Cancer.
Sarfati, D. (2019). Why social inequalities matter in the cancer continuum. In S. Vaccarella, J. Lortet-Tieulent, R. Saracci, D. I. Conway, K. Straif & C. P. Wild (Eds.), Reducing social inequalities in cancer: Evidence and priorities for research (IARC Scientific Publication No. 168). (pp. 15-24). Lyon, France: International Agency for Research on Cancer.
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
Journal - Research Article
Signal, V., Jackson, C., Signal, L., Hardie, C., Holst, K., McLaughlin, M., Steele, C., & Sarfati, D. (2020). Improving management of comorbidity in patients with colorectal cancer using comprehensive medical assessment: A pilot study. BMC Cancer, 20, 50. doi: 10.1186/s12885-020-6526-z
Gurney, J., Stanley, J., Jackson, C., & Sarfati, D. (2020). Stage at diagnosis for Māori cancer patients: Disparities, similarities and data limitations. New Zealand Medical Journal, 133(1508), 43-64. Retrieved from https://www.nzma.org.nz/journal
Signal, L. N., Edwards, R., Gage, R., Jackson, N., McKerchar, C., & Sarfati, D. (2020). The state of cancer prevention in Aotearoa New Zealand: Slow progress requires political leadership and investment for health and equity. Journal of Cancer Policy. Advance online publication. doi: 10.1016/j.jcpo.2019.100212
Fowler, H., Belot, A., Ellis, L., Maringe, C., Luque-Fernandez, M. A., Njagi, E. N., … Sarfati, D., … Rachet, B. (2020). Comorbidity prevalence among cancer patients: A population-based cohort study of four cancers. BMC Cancer, 20, 2. doi: 10.1186/s12885-019-6472-9
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
Znaor, A., Skakkebaek, N. E., Rajpert-De Meyts, E., Laversanne, M., Kuliš, T., Gurney, J., Sarfati, D., … Bray, F. (2019). Testicular cancer incidence predictions in Europe 2010-2035: A rising burden despite population ageing. International Journal of Cancer. Advance online publication. doi: 10.1002/ijc.32810
Stanley, J., Doughty, R. N., & Sarfati, D. (2019). A pharmaceutical dispensing-based index of mortality risk from long-term conditions performed as well as hospital record-based indices. Medical Care. Advance online publication. doi: 10.1097/mlr.0000000000001217
Gurney, J. K., Florio, A. A., Znaor, A., Ferlay, J., Laversanne, M., Sarfati, D., … McGlynn, K. A. (2019). International trends in the incidence of testicular cancer: Lessons from 35 years and 41 countries. European Urology. Advance online publication. doi: 10.1016/j.eururo.2019.07.002
Pilleron, S., Sarfati, D., Janssen-Heijnen, M., Vignat, J., Ferlay, J., Bray, F., & Soerjomataram, I. (2019). Global cancer incidence in older adults, 2012 and 2035: A population-based study. International Journal of Cancer, 144(1), 49-58. doi: 10.1002/ijc.31664
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
Dew, K., Barton, J., Stairmand, J., Sarfati, D., & Signal, L. (2019). Ascertaining patients’ understandings of their condition: A conversation analysis of contradictory norms in cancer specialist consultations. Health Sociology Review, 28(3), 229-244. doi: 10.1080/14461242.2019.1633945
Sarfati, D., Dyer, R., Sam, F. A.-L., Barton, M., Bray, F., Buadromo, E., Ekeroma, A., … Puloka, V., … Teng, A., … Vivili, P. (2019). Cancer control in the Pacific: Big challenges facing small island states. Lancet Oncology, 20(9), e475-e492. doi: 10.1016/S1470-2045(19)30400-0
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, 41(6), 1204-1211. doi: 10.2337/dc17-2557
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
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
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
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
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
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
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
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
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, 55(1), 161-178. doi: 10.1177/1440783318773880
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
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
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
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
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
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
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
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
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
