Data quality at the Singapore Cancer Registry: An overview of comparability, completeness, validity and timeliness.

Aim: To provide a comprehensive evaluation of the quality of the data at the Singapore Cancer Registry (SCR).

Methods: Quantitative and semi-quantitative methods were used to assess the comparability, completeness, accuracy and timeliness of data for the period of 1968-2013, with focus on the period 2008-2012.

Results: The SCR coding and classification systems follow international standards.

Evaluation of health outcomes in osteoarthritis patients after total knee replacement: a two-year follow-up.

Objectives: To quantify the improvement in health outcomes in patients after total knee replacement (TKR).

Methods: This was a two-year non-randomized prospective observational study in knee osteoarthritis (OA) patients undergone TKR. Patients were interviewed one week before, six months after, and two years after surgery using a standardized questionnaire including the SF-36, the Oxford Knee Score (OKS), and the Knee Society Clinical Rating Scale (KSS).

Total or partial knee replacement? Cost-utility analysis in patients with knee osteoarthritis based on a 2-year observational study.

The objective of this study was to evaluate incremental cost-utility of total knee replacement (TKR) versus unicompartmental knee arthroplasty (UKA) in patients with knee osteoarthritis (OA) of the medial compartment. A 2-year non-randomised prospective observational cohort study was conducted in unicompartmental knee osteoarthritis patients scheduled for TKR (n = 431) or UKA (n = 102). Costs were identified using administrative databases and health outcomes were measured using the SF-36 and the Oxford knee score (OKS) 1 week before, 6 months after, and 2 years after surgery.

BMI and diabetes risk in Singaporean Chinese.

Objective: Increased BMI is a robust risk factor for type 2 diabetes. Paradoxically, South Asians have relatively low BMIs despite their high prevalence of type 2 diabetes. We examined the association between BMI and incident type 2 diabetes because detailed prospective cohort data on this topic in Asians are scarce.

Reproductive variables, soy intake, and lung cancer risk among nonsmoking women in the Singapore Chinese Health Study.

Lung cancer among nonsmokers has emerged as a distinct clinicopathologic entity for which the etiology is still poorly understood, but which accounts for a significant proportion of the lung cancers among women. Although estrogens have been shown to have mitogenic effects in lung cells and interact with growth factor pathways in tumorigenesis, epidemiologic evidence for a link between reproductive hormones and lung cancer is sparse and inconsistent. We examined the effect of parity, age at menarche/menopause, cycle length and use of exogenous hormones, and dietary soy and soy isoflavonoid intake on lung cancer risk in a prospective cohort of middle-aged and elderly Chinese women in Singapore among whom 91% were lifetime nonsmokers.

Graduate public health education--Singapore's contribution to strengthening capacity in the region and beyond.

The year 2008 marks the 55th anniversary of the graduate public health programme in Singapore. This article traces the evolution of the programme-from the Diploma in Public Health in 1953 to the Master of Public Health in 2007--in response to changing challenges and needs. It also discusses the role Singapore can continue to play in addressing global inequities in access to public health education and in strengthening public health capacity in the region and beyond.

New ISSCR guidelines underscore major principles for responsible translational stem cell research.

The International Society for Stem Cell Research (ISSCR) task force that developed new Guidelines for the Clinical Translation of Stem Cells discusses core principles that should guide the responsible transition of basic stem cell research into appropriate clinical applications.

Sleep duration and coronary heart disease mortality among Chinese adults in Singapore: a population-based cohort study.

While some studies have found a positive association between both short and long sleep durations and cardiovascular disease (CVD), others have found an association only with a long or short sleep duration. In addition, there are limited data from non-Western populations on this topic. The authors examined the association between sleep duration and coronary heart disease (CHD) mortality among Chinese adults in Singapore (1993-2006), performing a prospective cohort study among 58,044 participants aged > or =45 years (55.

Coffee, tea, and incident type 2 diabetes: the Singapore Chinese Health Study.

Background: Increasing coffee intake was inversely associated with risk of type 2 diabetes in populations of European descent; however, data from high-risk Asian populations are lacking as are data on tea intake in general.

Objective: We investigated the prospective associations between intakes of coffee, black tea, and green tea with the risk of type 2 diabetes in Singaporean Chinese men and women.

Design: We analyzed data from 36 908 female and male participants in the Singapore Chinese Health Study aged 45-74 y in 1993-1998 who had multiple diet and lifestyle measures assessed and then were followed up between 1999 and 2004.

Incense use and respiratory tract carcinomas: a prospective cohort study.

Background: Incense use is an integral part of daily life in large parts of Asia. The burning of incense is a powerful producer of particulate matter and the smoke contains a multitude of well-characterized carcinogens. However, to the authors' knowledge, no convincing association has been reported between exposure to incense smoke and the development of cancer.

Chronic rhinosinusitis and risk of lung cancer in the Singapore Chinese Health Study.

Epidemiologic evidence suggests that chronic inflammatory conditions of the lung may increase lung cancer risk. These chronic conditions, such as chronic obstructive pulmonary disease and asthma, commonly coexist with chronic rhinosinusitis. We prospectively examined if chronic rhinitis or sinusitis was associated with lung cancer risk in the Singapore Chinese Health Study, a population-based cohort of 63,257 Singapore Chinese, who were aged 45-74 years when recruited between 1993 and 1998.

Cost effectiveness analysis of population-based serology screening and (13)C-Urea breath test for Helicobacter pylori to prevent gastric cancer: a markov model.

Aim: To compare the costs and effectiveness of no screening and no eradication therapy, the population-based Helicobacter pylori (H pylori) serology screening with eradication therapy and (13)C-Urea breath test (UBT) with eradication therapy.

Methods: A Markov model simulation was carried out in all 237900 Chinese males with age between 35 and 44 from the perspective of the public healthcare provider in Singapore. The main outcome measures were the costs, number of gastric cancer cases prevented, life years saved, and quality-adjusted life years (QALYs) gained from screening age to death.

Sleep duration, melatonin and breast cancer among Chinese women in Singapore.

Background: Sleep duration has been hypothesized to be inversely associated with breast cancer risk, possibly due to greater overall melatonin production in longer sleepers. However, data are inconclusive from the three studies conducted in Western populations on sleep duration and breast cancer risk.

Methods: We investigated the relationship between self-reported usual sleep duration determined at baseline and subsequent risk of breast cancer in the prospective, population-based cohort of the Singapore Chinese Health Study.

Cost-effectiveness analysis of Helicobacter pylori screening in prevention of gastric cancer in Chinese.

Objectives: The aim of this study was to evaluate the costs and effectiveness associated with no screening, Helicobacter pylori serology screening, and the 13C-urea breath test (UBT) for gastric cancer in the Chinese population.

Methods: A Markov model simulation was carried out in Singaporean Chinese at 40 years of age (n = 478,500) from the perspective of public healthcare providers. The main outcome measures were costs, number of gastric cancer cases prevented, life-years saved, quality-adjusted life-years (QALYs) gained from the screening age to death, and incremental cost-effectiveness ratios (ICERs), which were compared among the three strategies.

Morbidity and mortality in relation to smoking among women and men of Chinese ethnicity: the Singapore Chinese Health Study.

Objectives: We examined the association among cigarette smoking, smoking cessation and a broad range of cancer incidence and all cause and cause-specific mortality in a population-based cohort of adults of Chinese ethnicity in Singapore.

Methods: Subjects were 61,320 participants of the Singapore Chinese Health Study (44.5% men, aged 45-74 years, recruitment from 1993-1998) who were free of cancer at the baseline examination.

Validation of the Comprehensive ICF Core Set for Osteoarthritis (OA) in patients with knee OA: a Singaporean perspective.

Objective: To evaluate content validity and construct validity of the International Classification of Functioning, Disability and Health (ICF) Comprehensive Core Set for Osteoarthritis (OA) in Singapore.

Methods: Patients with knee OA completed case report forms, which included the SF-36, Self-administered Comorbidity Questionnaire (SCQ), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Health professionals completed the ICF Comprehensive Core Set for OA.

Green tea and black tea consumption in relation to colorectal cancer risk: the Singapore Chinese Health Study.

The relationships between green tea and black tea consumption and colorectal cancer risk were examined within the Singapore Chinese Health Study, a prospective cohort study of diet and cancer involving >60,000 men and women. Intake of green tea and black tea was assessed through in-person interviews. Incident cancer cases and deaths among cohort members were identified through record linkage of the cohort database with respective databases from the nationwide Singapore Cancer Registry and the Singapore Registry of Births and Deaths.

A prospective study of tobacco and alcohol use as risk factors for pharyngeal carcinomas in Singapore Chinese.

Background: Nasopharyngeal carcinoma (NPC) is a rare disease in most populations; however, in areas of Southeast Asia and North Africa and in the Arctic, undifferentiated NPC is the most frequent pharyngeal malignancy. Although smoking and alcohol have been established firmly as synergistic risk factors for other pharyngeal carcinomas, previous studies on the association between these risk factors and NPC have not been consistent. Therefore, the authors analyzed this relation in a cohort of Singapore Chinese, which is a population with a high incidence of NPC.

Vapor, dust, and smoke exposure in relation to adult-onset asthma and chronic respiratory symptoms: the Singapore Chinese Health Study.

Occupational factors contribute to a significant fraction of respiratory disease and symptoms. The authors evaluated the role of occupational exposures in asthma, chronic bronchitis, and respiratory symptoms in the Singapore Chinese Health Study, a population-based cohort of adults aged 45-74 years at enrollment in 1993-1998. Information on occupations and occupational exposures was collected at enrollment for 52,325 subjects for whom respiratory outcomes were obtained via follow-up interviews in 1999-2004.

Diabetes mellitus and risk of colorectal cancer in the Singapore Chinese Health Study.

The incidence of colorectal cancer is highest in populations that consume an energy-dense diet, have low intakes of vegetables and fruit, or lead a sedentary lifestyle. These factors may influence colorectal carcinogenesis via insulin pathways. We examined whether diabetes mellitus was associated with colorectal cancer in Singapore Chinese, whose body type and lifestyle profiles are distinct from those of Western populations.

Prospective study of dietary patterns and persistent cough with phlegm among Chinese Singaporeans.

Rationale: Using principal components analysis to examine dietary patterns complements the evaluation of individual food and nutrient intake in relation to health outcomes, but has not yet been applied to nonmalignant respiratory disease or symptoms.

Objective: To examine the relation between patterns of dietary intake at baseline and new onset of persistent cough with phlegm in a population-based cohort of Singapore Chinese.

Methods: A 165-item validated food frequency questionnaire was administered in-person at baseline in 1993.

Middle-aged and older Chinese men and women in Singapore who smoke have less healthy diets and lifestyles than nonsmokers.

Although studies in Western populations have shown that smokers have decreased dietary intakes of antioxidants and other health-related nutrients, this has not been established in oriental populations. This study aimed to identify differences in dietary and lifestyle characteristics between current, former, and never-smokers among middle-aged and older Chinese in Singapore. The subjects, 45-74 y old, were participants in the Singapore Chinese Health Study, a prospective cohort that enrolled 63,257 (27,959 men and 35,298 women) Chinese in Singapore between 1993 and 1998.