Abstract P1-07-10: Increasing population rates of in-situ breast cancer [DCIS] are associated with reduced breast cancer (BrCa) mortality. A case for screening mammography and "overdiagnosis" linked to outcome benefits
Bibliographic record
Abstract
Abstract INTRODUCTION: Following the first phase of this project [Ref 1], we correlate here the rates of DCIS with BrCaMOR, in two regions of Canada - British Columbia [BC] and Atlantic Provinces [Atl.P]. We previously reported higher compliance in screening mammography [ScreenMam] and therapeutic [TH*] guidelines [GUIDELINES] for both DCIS and invasive BrCa in BC compared with Atl.P [Ref. 2]. METHODS: Annual age-specific rates [cases / 100,000 population] of DCIS, and BrCaMOR between BC vs Atl.P, were obtained for 17 age groups of 5 years (years 0-4 to 85+) and averaged each 5-year period from 1975-1979 up to 2005-2009. To compare age distribution, DCIS rates and BrCaMOR between the two regions, we selected four birth cohorts, age 30-34, 35-39, 40-44 and 45-49 in 1975-1979. From those, we tabulated the DCIS incidence and BrCaMOR for each birth cohort when they reached ages 50-54 and 60-64. We assumed that the rates of DCIS reflect annual ScreenMam practices. Data were obtained from the Public Health Agency of Canada based on the Canadian Cancer Registry database at Statistics Canada. RESULTS [N/100,000 population]British ColumbiaAtlantic ProvincesAge / years DCISBrCaMORDCISBrCaMORAge 50 â– 54 1980-8413.152.24.056.41985-8921.246.68.056.11990â–9429.244.421.449.91995â–9945.543.830.050.1Age 60â – 64 1990-9428.072.123.186.21995-9949.361.935.276.62000-0449.365.845.669.42005â–0951.453.141.059.4 CONCLUSIONS: 1. Our study shows across all age cohorts higher rates of DCIS and lower BrCaMOR in BC compared to Atl.P - results consistent with higher ScreenMam rates in BC than Atl.P. 2. These data are compatible with the concept that a higher diagnostic rate for early lesions such as DCIS [i.e. frequently designated as "Overdiagnosis"] by ScreenMam, and subsequent earlier Guideline TH*, contributes to lower BrCaMOR. *TH Guidelines: surgery, radiation, Tamoxifen for DCIS; and the same + chemotherapy for early invasive disease. Citation Format: Ragaz J, Qian H, Shakeraneh S, Fox J, Wilson KS, Simpson JS, Yoon J-Y, Wong H. Increasing population rates of in-situ breast cancer [DCIS] are associated with reduced breast cancer (BrCa) mortality. A case for screening mammography and "overdiagnosis" linked to outcome benefits. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-07-10. References: 1. J. Ragaz, H. Wong, H. Qian, J.Fox, K. Wilson, A. Coldman: Cancer Research, May 1, 2015 75; P3-07-28 2. J. Ragaz, H. Wong, H. Qian: Cancer Research Feb 2010; 69(24 Supplement):2063-2063.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.015 | 0.003 |
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".