Biostatistics and Epidemiology Unit

The Biostatistics and Epidemiology Unit provides statistical and epidemiological support for clinical trials and studies conducted at the National Cancer Centre Singapore. This is in the form of consultations, collaborations as well as teaching. We also initiate and engage in relevant areas of applied biostatistics and epidemiology research.

The conduct of good biomedical research requires the appropriate disease expertise and rigorous research methodology combined with strong quantitative analyses. The added value of statistical and epidemiological techniques to biomedical research is well recognised. In biomedical studies the correct design, analysis and interpretation of the study all require the development and application of good statistical and/or epidemiological methods.

The design and conduct of scientifically sound clinical studies are essential for generating reliable findings that ultimately benefit patients. The use of inefficient or erroneous methodology can lead to serious misinterpretations of the research findings. This could eventually result in patients receiving suboptimal or worse still, inappropriate treatment. To mitigate these risks, the unit applies principles of evidence-based medicine when designing and analysing studies, ensuring that conclusions drawn are both robust and clinically meaningful.

Although a wide range of statistical and epidemiological techniques has already been developed, only a relatively small proportion is routinely applied in practice. A key reason for this is that many methods have yet to make the transition from the ‘statistical laboratory’ to clinical use. Nevertheless, these approaches have the potential to enhance multiple aspects of the biomedical research process, ultimately resulting in more accurate and reliable conclusions being drawn, for example in evaluating the effectiveness of new treatments. This has important ethical implications as patients consent to have their data used for biomedical research with the expectation that the information that they provide will be used in the most optimal way to provide benefits for future patients and potentially themselves as well. There is therefore a need for continued research to evaluate, refine, and integrate advanced biostatistical and clinical research methodologies into routine clinical practice.

Furthermore, many challenges in biomedical research could be addressed through the application of more appropriate (albeit less well known) statistical methods, enabling improved data analysis and interpretation of the data. This can be achieved through the conduct of applied biostatistics research and teaching. Current areas of focus include prognostic modelling, clinical trial methodology, applications of Bayesian statistics in medicine and statistical methods in genetics.

Selected publications:

1. Chen HLR, Chong QD, Tay B, Zhou S, Wong EYT, Seow-En I, Tan KK, Wang Y, Seow A, Tan KE, Tan BHI, Tan SH. Trends of early-onset colorectal cancer in Singapore: an epidemiological study of a multi-ethnic population. JMIR Public Health Surveill. 2025;11:e62835. 
2. Yuen J, Zhou S, Caeser R, Venkatramani M, Ishak DNB, Li ST, Zhang Z, Chiang J, Chan SH, Ngeow J. Multi-locus inherited neoplasia alleles syndromes in cancer: implications for clinical practice. Eur J Hum Genet. 2025;33:289–296. 
3. Toh HC, Yang MH, Wang HM, Hsieh CY, Chitapanarux I, Ho KF, Hong RL, Ang MK, Colevas AD, Sirachainan E, Lertbutsayanukul C, Ho GF, Nadler E, Algazi A, Lulla P, Wirth LJ, Wirasorn K, Liu YC, Ang SF, Low SHJ, Tho LM, Hasbullah HH, Brenner MK, Wang WW, Ong WS, Tan SH, Horak I, Ding C, Myo A, Samol J, Gemcitabine, carboplatin, and Epstein Barr virus-specific autologous cytotoxic T lymphocytes for recurrent or metastatic nasopharyngeal carcinoma: VANCE, an international randomized Phase 3 trial, Ann Oncol. 2024;35(12):1181–1190. 
4. Kee W, Ng KYY, Liong SZ, Zhou S, Chee SK, Lim CW, Lam JYC, Tan JTH, Ong HS, Chan WH, Lim EKW, Lim CH, Eng AKH, Lee CJZ, Ng MCH. Real-world outcomes for localised gastro-oesophageal adenocarcinoma treated with perioperative FLOT and prophylactic G-CSF support in a single Asian centre. Cancers (Basel). 2024;16(21):3697. 
5. Tan RYC, Ong WS, Lee KH, Park S, Iqbal J, Park YH, Lee JE, Yu JH, Lin CH, Lu YS, Ono M, Ueno T, Naito Y, Onishi T, Lim GH, Tan SM, Lee HB, Koh J, Han W, Im SA, Tan VKM, Phyu N, Wong FY, Tan PH, Yap YS. Outcomes in nonmetastatic hormone receptor-positive HER2-negative pure mucinous breast cancer: a multicenter cohort study. J Natl Compr Canc Netw. 2024;22(2):e237121. 
6. Miao J, Wang L, Tan SH, Li JG, Yi J, Ong EHW, Tan LLY, Zhang Y, Gong X, Chen Q, Xiang YQ, Chen MY, Guo Y, Lv X, Xia WX, Tang L, Deng X, Guo X, Han F, Mai HQ, Chua MLK, Zhao C. Adjuvant capecitabine following concurrent chemoradiotherapy in locoregionally advanced nasopharyngeal carcinoma: a randomized clinical trial. JAMA Oncol. 2022;8(12):e224656. 
7. Ng M, Chen S, Ong WS, Balachander A, Seet A, Yeong J, Sutiman N, Lim TKH, Lee B, Guo YA, Leong WF, Lee SS, Lam J, Choo SP, Skanderup AJ, Biswas SK, Tai D, Chowbay B. A phase 1b study of OXIRI in pancreatic adenocarcinoma patients and its immunomodulatory effects. Int J Cancer. 2022 ;151(3):435–449. 
8. Tan AC, Tan SH, Zhou S, Peters S, Curigliano G, Tan DSW. Efficacy of targeted therapies for oncogene-driven lung cancer in early single-arm versus late phase randomized clinical trials: A comparative analysis. Cancer Treat Rev. 2022;104:102354.