Primary care physicians'knowledge,attitude and perception towards homosexuality in Singapore

Aims:This study aim to gain insights into attitudes,acceptance and knowledge levels among family physicians toward homosexual people,which are important as they may affect care among this at-risk group.Methods:An anonymized self-administered questionnaire in English was posted with the assistance of the College of Family Physicians Singapore in February 2015 to its 1529 members with self-addressed,pre-stamped envelopes for replies.The questionnaire included demographic questions such as age group,gender,religion,ethnicity,marital status and place of practice.Questions and scales that measured attitude,acceptance,knowledge and perception of colleagues who are homosexual were also included in the questionnaire.Results:451 responses(29.5%)were obtained,of which 441 were valid(28.84%).About 52.8%of participants were found to have negative,8.9%neutral and 38.3%positive attitudes toward homosexuality.Most(75.6%)were accepting of homosexuals,with 9.3%neutral and 15.1%not accepting.Knowledge levels were poor,with a mean score of 6.9 out of a maximum of 13.A strong correlation was found between the attitudes towards lesbians and gay men(ATLG)and acceptance of homosexuals scales(r=0.69,P<0.001),with moderate correlations between acceptance and knowledge(r=0.54,P<0.001)and ATLG and Knowledge(r=0.54,P<0.001).Conclusion:Despite majority of family physicians having negative attitudes towards homosexuality,most are able to accept homosexuality.With better education in sexual orientation in the medical educational curriculum,the increase in knowledge will lead to better care for people with homosexuality.

Human epidermal growth factor receptor 2 positive rates in invasive lobular breast carcinoma: The Singapore experience

BACKGROUND Invasive lobular carcinomas(ILC)form 5%-10%of breast cancer and rarely show overexpression of human epidermal growth factor receptor 2(HER2).AIM To describe the prevalence and prognostic factors of HER2 positive(HER2+)ILC in an Asian population.METHODS A retrospective review of patients with ILC seen between January 1985 and March 2018 at various SingHealth medical institutions was conducted.Demographic and clinical data were collected from medical records.We examined clinicopathological characteristics and survival in relation to HER2 status.RESULTS A total of 864 patients were included.Prevalence of HER2 positivity was 10.1%(87 patients).Compared with HER2 negative(HER2-)ILC,HER2+ILC was associated with a higher proportion of estrogen receptor negative(24.4%vs 5.9%,P<0.001),progesterone receptor negative(PR-)(40.2%vs 24%,P=0.002)and grade 3 tumours(Grade 3,29.0%vs 10.2%,P<0.001).Overall survival rate was poorer in patients with HER2+compared to HER2-ILC(56.7%vs 72.9%alive at 10 years;hazard ratio 1.87,95%confidence interval:1.21-2.90,P=0.004).Based on multivariate analysis,negative prognostic factors for overall survival included HER2 positivity,PR negativity,older age,Indian ethnicity and higher tumour stage.CONCLUSION Prevalence of HER2+ILC was 10.1%.HER2+ILC was more likely to have poorer prognostic features such as estrogen receptor negative,PR-and higher tumour grade,and have a poorer survival.