A181 GEOGRAPHIC IMPACT ON SCREENING AND DEVELOPMENT OF CERVICAL NEOPLASIA IN INFLAMMATORY BOWEL DISEASE
Notice bibliographique
Résumé
Abstract Background While the risk of cancer in inflammatory bowel disease (IBD) is elevated, studies indicate a lower odds of gynecological cancers. Cervical cancer has become relatively preventable as a result of screening programs. However, geographic access impacts screening, possibly resulting in higher rates of cancer in rural areas. Aims To investigate in the IBD population: (1) the odds of cervical neoplasia (squamous intraepithelial neoplasia grade III or cervical cancer) compared to matched controls, (2) screening rates (Pap smears), and (3) impact of urban vs rural residence on these estimates. Methods We conducted a population-based matched cohort study using administrative healthcare databases in Alberta to identify females with IBD (n=22,245), age- and sex-matched 10-to-1 to controls (n=161,070) from fiscal years 2003–2021. The Alberta Cancer Registry provided morphology and diagnosis date for cervical neoplasia. Physician Claims provided Pap smears. Screening rates were defined as Pap smears per person-year (PY), with eligible Pap smears being those received by individuals aged 21–69, as per provincial screening guidelines. The Provincial Registry provided annual geographic data indicating urban vs rural residency. Average annual percentage change (AAPC) in screening and incidence of cervical neoplasia was calculated using Poisson regression. Conditional logistic regression compared cervical neoplasia in cases and controls, reported as odds ratios (ORs) and 95% confidence intervals (CIs), and evaluated rurality as an effect modifier using an interaction term. Two-sample t-tests compared mean Pap smears per PY between urban and rural populations. Results Females with IBD have lower odds of both cervical cancer (OR: 0.65; 95%CI: 0.47, 0.92) and neoplasia (OR: 0.76; 95%CI: 0.68, 0.84) compared to controls, but rural status was not a modifier (p=0.38). Screening rates in those with IBD were not significantly different from controls (p=0.49). Rural individuals with IBD were screened less than their urban counterparts (0.086 vs 0.30 Pap smears per PY, p<0.001), and a similar pattern was observed in controls (0.087 vs 0.29 Pap smears per PY, p<0.001). The proportion of eligible individuals with IBD receiving Pap smears decreased over time (AAPC: −5.15; 95%CI: −5.30, −4.99), while the diagnosis of cervical neoplasia was stable (AAPC: −0.14; 95%CI: −2.03, 1.79). Conclusions Individuals with IBD had lower odds of cervical neoplasia and cancer, regardless of rural vs urban status. Screening was lower for rural individuals in both IBD and non-IBD populations. Although screening rates declined in individuals with IBD, the detection of cervical neoplasia remained stable. Future studies should explore barriers to and timing of screening, especially in rural areas, as well as the reasons for the reduced risk of cervical neoplasia in IBD. Yearly proportion of eligible individuals receiving a Pap smear in the IBD population (top) and yearly rate of cervical neoplasia diagnoses (bottom) in individuals with IBD. Funding Agencies CIHR
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 | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| 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) | 0,004 | 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 ».