Breast cancer wait times: Use of breast screening clinics affect presenting stage
Bibliographic record
Abstract
10686 Background: Wait times in the navigation of the diagnostic and therapeutic system of breast cancer have been increasingly investigated. It is inherently apparent that an earlier diagnosis would lead to an improved prognosis in breast cancer. In Ontario (Canada) Breast Screening Clinics (OBSC) allow direct access of patients to mammograms. Methods: A retrospective review of all breast cancer patients seen in the regional cancer centre in the year 2003 was performed. Wait times between the following events were recorded: first symptom to presentation to medical system, presentation to mammogram, mammogram to biopsy, biopsy to surgery, surgery to consultation at cancer centre. Results: In 2003, 277 new cases of breast cancer were seen at the regional cancer centre. Identified median waiting times were as follows: mammogram to diagnostic biopsy - 18.5 days, diagnostic biopsy to definitive surgery - 28 days; surgical consultation to definitive surgery - 13 days; definitive surgery to oncology consultation - 31 days. Some wait times were longer in those patients who did not have close geographic access to OBSC and a regional cancer centre: mammography to diagnostic biopsy was doubled (17 to 34 days) and surgical consult to surgical date was doubled (12 vs 26.5 days). Eighty per cent (n = 27) of patients identified by OBSC presented with Stage I or less breast cancer vs 37% of all other patients. Seventeen per cent of patients seen at the regional cancer centre were less than 50 years of age and not eligible for the OBSC. Conclusions: The wait times reported are in keeping with the current experience in Ontario, Canada.[1] It is most likely that access to a breast-screening clinic allows self-selection of a more highly motivated population. This population of patients consistently presented with earlier stage and more curable disease. The challenge that remains is to increase the number of patients that access breast-screening clinics. Presently, only 13% of presenting patients seen at the regional cancer centre were identified by the OBSC. We are identifying barriers to the use of this very effective strategy. [1] Cancer Care Ontario. Ontario Wait Times Strategy. www.health.gov.on.ca. [Table: see text]
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.006 | 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 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".