Nina Afshar

Trends and Inequalities in cancer Survival in Victoria, Australia

N.Afshar photo

Supervisors names: Professor Dallas English and Associate Professor Roger Milne

Cancer is the second leading cause of mortality in the world behind cardiovascular diseases. Epidemiological evidence has revealed that inequalities in cancer survival exist within and between countries. Poorer cancer survival for people with lower socio-economic position, and for those from rural or remote areas, has been well documented in high-income countries; however, the causes of cancer survival differences are not fully understood. Identifying and understanding the complex mechanisms behind these differences will help to establish effective interventions to reduce inequalities.

Causal mediation analysis is a key method to clarify how intermediate variables (mediators) contribute to the observed association between an exposure and an outcome. Most epidemiological studies have applied the traditional approach of mediation analysis by adjusting for the mediators in regression models. Recent methodological papers have shown that under several conditions this traditional method fails and produces flawed conclusions. Alternative methods have been recommended to improve the validity and interpretation of mediation analysis.

The aim of this doctoral work is to explore variations in cancer survival by socio-economic position, place of residence and sex using linked data from the Victorian Cancer Registry and other population-based health-related datasets. A novel method of mediation analysis will be used to identify the underlying reasons for survival differences in bowel cancer in Victoria.

PhD scholarship and funding body: Australian Government Research Training Program Scholarships (RTP)