A review of the Inuit oncology patients treated at the Ottawa Hospital Cancer Centre.
Bibliographic record
Abstract
e17563 Background: Cancer is a major health concern among Canada’s northern Inuit population. Limited Inuit specific data exists on the geographical isolation and the effect on treatment outcomes of Inuit referred to urban hospitals for cancer treatment. Methods: A retrospective chart review of all Inuit referred to the Ottawa Hospital Cancer Centre from Nunavut, Canada (distance: 1298 miles) between 2001-2011 was conducted. Demographic, diagnostic and treatment related information was collected on all patients, including the number of visits made by each Inuit patient from Nunavut to OHCC for treatment. Results: 234 Inuit (male: 74, female: 160) were referred to OHCC with a diagnosis of cancer. Mean age at diagnosis was 58.5 years (sd 14.61). Over half the patients were current smokers (54%) and 39% of patients had a history of tuberculosis (TB). Among Inuit men, lung (n=32, 43%), colorectal (n=11, 14%) and nasopharyngeal (n=9, 12%) cancer were the most common diagnosis. Among Inuit women, the most common cancers were lung (n=72, 45%), colorectal (n=32, 20%), breast (n=21, 13%), cervical (n=11, 7%) and nasopharyngeal (n=7, 4%). Metastatic disease at presentation was common (n=76, 38%). Primary cancer was amenable to surgery in n=57 patients. An equivalent number of patients (n=82) received adjuvant/definitive radiation therapy (RXT) and adjuvant chemotherapy, with n=52 receiving chemoradiation. Palliative RXT and chemotherapy was received by 64 and 51 patients, respectively. Among patients receiving chemotherapy, there were no cases of TB reactivation and no treatment related serious adverse outcomes or deaths. Average number of trips made to Ottawa for treatment was n=7 (sd 7.90) with the upper quartile averaging n=10 trips. Conclusions: Lung, colorectal and nasopharyngeal cancers are over-represented among Canadian Inuit, who often present with advanced disease. Travel burden is significant among patients receiving treatment. Improved cancer screening and oral molecularly targeted therapies that can be delivered in remote northern communities are likely to improve the experience and treatment outcomes among Canadian Inuit.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.007 | 0.014 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".