Inferior survival among Aboriginal children with cancer in Ontario
Bibliographic record
Abstract
BACKGROUND: Pediatric cancer distribution and outcomes have not been examined in Canadian Aboriginal children. The objective of this study was to describe the distribution, event-free survival, and overall survival of Aboriginal children with malignancies who reside in Ontario compared with non-Aboriginal children. METHODS: This population-based study included 10,520 Ontario children (aged <18 years) who were diagnosed with cancer between 1985 and 2011. Patients were identified from the Pediatric Oncology Group of Ontario Networked Information System database. Aboriginal children were identified by self-reported ethnicity or postal code on a Native reserve at diagnosis. Descriptive statistics of the patients were presented and compared using the Fisher exact test. Event-free and overall survival probabilities were calculated for Aboriginal and non-Aboriginal children, described using Kaplan-Meier curves, and compared using log-rank tests. RESULTS: In total, 65 Aboriginal children and 10,364 non-Aboriginal children with malignancy were identified. The distribution of malignancy type was similar between the 2 groups. There were no significant differences in baseline characteristics, presence of metastatic disease, or treatment approach (clinical trial, standard of care, or individualized protocol) between the groups. The 5e-year event-free survival rate (± standard error) was 56.3% ± 6.2% among Aboriginal children versus 72.8% ± 0.4% among non-Aboriginal children (P = .0042), and the 5-year overall survival rate was 64% ± 6.0% versus 79.3 ± 0.4% (P = .0017), respectively. The cause of death did not vary according to Aboriginal ethnicity. CONCLUSIONS: Survival was significantly inferior among Aboriginal children who had cancer compared with non-Aboriginal children who had cancer in Ontario. Future studies are required to define the etiology of this disparity, evaluate the issue nationally, and create interventions to improve outcomes for Aboriginal children.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".