Temporal Trends in New Diagnoses of Colorectal Cancer with Obstruction, Perforation, or Emergency Admission in Ontario: 1993–2001
Notice bibliographique
Résumé
OBJECTIVES: Previous studies have shown that patients newly diagnosed with colorectal cancer requiring emergency admission to hospital or presenting with obstruction or perforation (defined here as OPE) have advanced disease. None of these studies, however, has evaluated temporal trends in these adverse outcomes, which may reflect screening failures. We evaluated temporal trends in the proportion of Ontario patients with a new diagnosis of colorectal cancer and OPE. METHODS: Data were obtained from four sources: the Ontario Cancer Registry (OCR); the Canadian Institute for Health Information (CIHI) database, which contains diagnostic information on all patients discharged from hospitals; the Ontario Health Insurance Plan (OHIP) database, which records all physician claims in Ontario; and the Registered Persons Database, which contains demographic information on all Ontario residents covered under OHIP. We calculated the proportion of patients (>/=20 yr) with a new diagnosis of colorectal cancer recorded in CIHI who presented with OPE between 1993 and 2001. These patients were assigned to one of three cohort years: 1993-1995, 1996-1998, or 1999-2001. Those who received chemotherapy, radiotherapy, or palliative care before their first admission to hospital were excluded. We repeated the analysis using the number of OPE patients identified from CIHI in the numerator, and the number of patients (>/=20 yr) with a new diagnosis of colorectal cancer recorded in the OCR in the denominator. Adjusted risk of OPE was calculated using a logistic regression model. RESULTS: Between 1993 and 2001, 59,670 patients with a new diagnosis of colorectal cancer were recorded in the CIHI database and 54,103 in the OCR. The proportion of these patients with OPE recorded in the CIHI decreased significantly over time: 23.8% (95% CI = 23.2-24.4%) during 1993-1995, 19.4% (95% CI = 18.8-20.0%) during 1996-1998, and 18.1% (95% CI 17.6-18.6%) during 1999-2001 (a 24% relative decrease over time). The relative decrease calculated from OCR data was similar. The adjusted relative decrease in the proportion of patients with OPE during 1993-2001 was 31%. CONCLUSIONS: Much greater emphasis on screening is needed since approximately 20% of patients with a new diagnosis of colorectal cancer in 1999-2001 presented with OPE.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».