Abstract P1-10-09: Access to HER2 Testing in Early Stage Breast Cancer (ESBC) in a Single Payor, Public Healthcare System — Ontario (ON), Canada
Notice bibliographique
Résumé
Abstract Background: In ON, testing for HER2 overexpression in ESBC was approved, along with trastuzumab (T) treatment with chemotherapy for HER2 positive (IHC = 3 or FISH ≥2.0) tumors in 2005. Guidelines for testing and treatment must be met for provincial T reimbursement. To study adherence to HER2 testing and T utilization guidelines in ESBC, we first describe patient access to HER2 testing by age, tumor, stage, urbanicity and income. Methods: A population-based retrospective cohort of ESBC patients diagnosed in 2006 and 2007 was identified using the Ontario Cancer Registry and for whom ≥1 pathology report was available from Cancer Care Ontario (CCO). All BC-related pathology reports were individually reviewed to identify early stage, resected, primary BC. Information was collected on surgical procedure, TN stage, histologic grade, receptor status (ER/PR) and HER2 test provision. Linkage to other administrative databases provided income quintile, urban vs. rural residence and institution of diagnosis. Odds ratios were calculated to determine association of HER2 testing with any pathologic or socioeconomic factors. Results: The 2-year cohort contains 13,430 ESBC patients, 60% of which had breast conserving surgery. 29,746 (2.2/patient) pathology reports were reviewed. 13% of the cohort had rural residences, and 95% were alive at end of follow-up. Age at diagnosis was distributed as: 5% < 40 years, 18% 40-49 years, 25% 50-59 years, 24% 60- 69 years, 18% 70-79 years and 10% ≥80 years. Stage at diagnosis was: 35% stage I, 32% stage II, 10% stage III and 22% stage unknown after removing all stage IV. No differences in HER2 testing were observed for patients across income quintiles (P>0.3550). Patients ≥80 years (P<0.0001) and <40 years (p=0.0074) had significantly lower odds of receiving ≥1 HER2 test than patients 40-49 years. ESBC of higher histologic grade had significantly greater odds (P<0.0001) of ≥1 HER2 test compared to grade I ESBC. Patients from rural areas had lower odds of HER2 testing compared to urban patients (P<0.0001). Conclusions: For the 2 years 2006-2007: 13,430 ESBC patients were identified from the OCR for which ≥1 pathology report was available from CCO. Age, stage at diagnosis, and surgical procedure were representative of an ESBC population. HER2 testing was universally available per Ontario policy, but not all reports were submitted to CCO. The odds of having a documented HER2 test were not affected by income, but testing was more likely to be documented for high grade tumours and less likely to be documented for the youngest and oldest women and those with rural residence. Pathology reports missing from CCO are being sought. Adherence to guidelines for testing, treatment with T and cardiac monitoring during treatment will be assessed. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-10-09.
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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
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 source (Gemma direct ou Codex distillé), 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 ».