Breast Cancer Survival in Ontario's First Nations Women: Understanding the Determinants
Notice bibliographique
Résumé
This study builds on previous research showing that breast cancer survival is poorer for First Nations (FN) women compared to other Ontario women. Few studies have examined breast cancer survival in Indigenous populations compared to general populations; all of these report poorer survival among Indigenous people. Fewer still have examined potential factors related to the poorer survival, but these often suggest poorer prognosis even after adjustment for them. Study objectives were: to compare the distribution of demographic, prognostic and treatment factors between FN and non-FN women; to investigate factors associated with later diagnosis in FN women; to compare stage specific survival for FN and non-FN women controlling for important factors potentially associated with breast cancer survival; and to examine potential determinants of survival for FN women by stage at diagnosis. A case-case design was employed to compare FN women (n=287) diagnosed with invasive breast cancer to a frequency-matched random sample of women (n=671) from the general population diagnosed with breast cancer within the Ontario Cancer Registry. Women were matched (2:1) on period of diagnosis (1995-1999 and 2000-2004), age at diagnosis (<50 vs. 50≥), and Regional Cancer Centre (RCC). Stage at diagnosis and data relevant to the determinants of breast cancer survival were collected from medical charts at the RCCs. FN women were diagnosed with breast cancer at later stages compared to non-FN women. Having a non-screened method of detection and increasing BMI were associated with a later breast cancer diagnosis. FN women with comorbidity however were less likely to be diagnosed at a later stage. An unforeseen novel finding was that the survival disadvantage occurred after an early breast cancer diagnosis, whereas the survival experiences for those diagnosed at stages II+ were similar. In a multivariate analysis, elevated risk was observed for FN women in stage I, and significant risk was seen in women with comorbidity. These findings are actionable and can be used to improve the prognosis of FN women with breast cancer. It is likely that the same or similar factors are largely responsible for the survival disadvantage observed among Ontario FN people for most other major cancers.
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 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 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 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 ».