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dc.contributor.authorBhoo-Pathy, Nirmala
dc.contributor.authorHartman, Mikael
dc.contributor.authorYip, Cheng-Har
dc.contributor.authorSaxena, Nakul
dc.contributor.authorTaib, Nur Aishah
dc.contributor.authorLim, Siew-Eng
dc.contributor.authorIau, Philip
dc.contributor.authorAdami, Hans-Olov
dc.contributor.authorBulgiba, Awang M.
dc.contributor.authorLee, Soo-Chin
dc.contributor.authorVerkooijen, Helena M.
dc.date.accessioned2012-04-20T17:44:44Z
dc.date.issued2012
dc.identifier.citationBhoo-Pathy, Nirmala, Mikael Hartman, Cheng-Har Yip, Nakul Saxena, Nur Aishah Taib, Siew-Eng Lim, Philip Iau, Hans-Olov Adami, Awang M. Bulgiba, Soo-Chin Lee, and Helena M. Verkooijen. 2012. Ethnic Differences in Survival after Breast Cancer in South East Asia. PLoS ONE 7(2): e30995.en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:8605303
dc.description.abstractBackground: The burden of breast cancer in Asia is escalating. We evaluated the impact of ethnicity on survival after breast cancer in the multi-ethnic region of South East Asia. Methodology/Principal Findings Using the Singapore-Malaysia hospital-based breast cancer registry, we analyzed the association between ethnicity and mortality following breast cancer in 5,264 patients diagnosed between 1990 and 2007 (Chinese: 71.6%, Malay: 18.4%, Indian: 10.0%). We compared survival rates between ethnic groups and calculated adjusted hazard ratios (HR) to estimate the independent effect of ethnicity on survival. Malays (n = 968) presented at a significantly younger age, with larger tumors, and at later stages than the Chinese and Indians. Malays were also more likely to have axillary lymph node metastasis at similar tumor sizes and to have hormone receptor negative and poorly differentiated tumors. Five year overall survival was highest in the Chinese women (75.8%; 95%CI: 74.4%–77.3%) followed by Indians (68.0%; 95%CI: 63.8%–72.2%), and Malays (58.5%; 95%CI: 55.2%–61.7%). Compared to the Chinese, Malay ethnicity was associated with significantly higher risk of all-cause mortality (HR: 1.34; 95%CI: 1.19–1.51), independent of age, stage, tumor characteristics and treatment. Indian ethnicity was not significantly associated with risk of mortality after breast cancer compared to the Chinese (HR: 1.14; 95%CI: 0.98–1.34). Conclusion: In South East Asia, Malay ethnicity is independently associated with poorer survival after breast cancer. Research into underlying reasons, potentially including variations in tumor biology, psychosocial factors, treatment responsiveness and lifestyle after diagnosis, is warranted.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0030995en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283591/pdf/en_US
dash.licenseLAA
dc.subjectmedicineen_US
dc.subjectepidemiologyen_US
dc.subjectpublic healthen_US
dc.subjectcancers and neoplasmsen_US
dc.subjectglobal healthen_US
dc.subjectnon-clinical medicineen_US
dc.subjecthealth care policyen_US
dc.subjectobstetrics and gynecologyen_US
dc.subjectoncologyen_US
dc.titleEthnic Differences in Survival after Breast Cancer in South East Asiaen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorAdami, Hans-Olov
dc.date.available2012-04-20T17:44:44Z
dc.identifier.doi10.1371/journal.pone.0030995*
dash.contributor.affiliatedAdami, Hans-Olov


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