S1112 Incidence and Outcomes of Prostate Cancer in Patients With Inflammatory Bowel Disease: A Canadian Population-Based Study
Notice bibliographique
Résumé
Introduction: Prostate cancer is the most common cancer among men, and recent studies have shown an increased risk of prostate cancer in those with inflammatory bowel disease (IBD). Yet, other than expert recommendations for PSA screening in patients above 40 with ileal-pouch anastomoses, the screening and treatment guidelines for prostate cancer in men with IBD do not differ from the general population. The goals of our study were to assess if patients with IBD are: 1) at increased odds of prostate cancer; 2) at increased odds of advanced cancer and death, and, 3) receiving different first-line treatments for prostate cancer. Methods: We conducted a population-based matched cohort study using a Canadian population-based administrative database from April 2002 to March 2018 to identify patients with IBD (n = 17,022), and age- and sex-matched 10-to-1 to healthy controls (n = 136,819). Specific data was then obtained from a cancer-specific database. Average annual percentage change (AAPC) in age standardized incidence of prostate cancer was calculated using Poisson regression. Comparisons were done using either Wilcoxon Rank-sum or Fisher’s exact tests. Odds ratios (ORs) and their 95% confidence intervals (95%CI) were calculated using conditional logistic regression for the overall odds of prostate cancer diagnosis and logistic regression for ORs specific to only those with prostate cancer. Results: Of the patients included, 1.58% of patients with IBD were diagnosed with prostate cancer, in comparison to 2.65% in the control group [OR 0.65, (95%CI 0.57, 0.73)]. From 2002 to 2018 the incidence of prostate cancer decreased in those with IBD (AAPC=-3.65%; 95%CI -6.56, -0.64) and in the control group (AAPC=-1.74%; 95%CI: -2.56, -0.92). The median age of diagnosis of prostate cancer was similar between the two groups (P = 0.83). Among patients with prostate cancer, those with IBD had an increased odds of having stage IV prostate cancer (OR 2.94 [95%CI: 1.95, 4.42]), as well as having surgery as their first line of treatment (OR 1.3 [95%CI: 1.03, 1.69]). The odds of death from prostate cancer were increased among patients with IBD (OR 2.46 [95%CI: 1.47, 4.09]). Conclusion: While prostate cancer was less common in those with IBD compared to controls, a diagnosis of prostate cancer is associated with more advanced stage and mortality in these patients. Further studies assessing the risk of prostate cancer in patients with IBD are critical in adapting our cancer screening and treatment options to this population (Table 1). Table 1. - Incidence, age and stage of diagnosis, treatment and death of prostate cancer in patients with IBD. Average annual percent change shows the change in incidence of prostate cancer from April 1, 2002 to March 31, 2018. Odds ratios (OR) with 95% confidence intervals (CI) compare outcomes (diagnosis of prostate cancer, stage at diagnosis, treatment, and mortality) in those with IBD as compared to controls IBD (n = 269) Control group (n = 3628) Odds Ratio (95%CI) Average annual percentage change (%) -3.65 (95% CI: -6.56, -0.64) -1.74 (95%CI: -2.56, -0.92) Being diagnosed with Prostate Cancer: 0.65 (0.57, 0.73) Median age in years (Q1, Q3) 66 (60, 73) 67 (60,73) Stage at diagnosis (n, %) I & II 165 (61.3%) 2282 (62.9%) 0.94 (0.94, 1.46) III 23 (9.4%) 328 (10.6%) 0.94 (0.60, 1.46) IV 31 (12.7%) 154 (5.0%) 2.93 (1.95, 4.42) Unknown/Missing data 26 (9.7%) 864 (23.8%) First-line treatment Surgery 130 (48.3%) 1503 (41.4%) 1.32 (1.03, 1.69) Hormone-based therapy 59 (21.9%) 761 (21.0%) 1.06 (0.78, 1.43) Radiotherapy 15 (5.9%) 409 (11.3%) 0.46 (0.27, 0.79) Surveillance/No treatment 64 (23.8%) 939 (25.6%) 0.89 (0.67, 1.20) Death Prostate cancer death 36 (13.3%) 73 (2.0%) 2.46 (1.47, 4.09)
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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 | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,006 |
| Études des sciences et des technologies | 0,002 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 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 ».