Trends in prostate biopsy in Ontario, 1992-2014: a cohort study
Bibliographic record
Abstract
BACKGROUND: Prostate cancer is a substantial public health concern; however, in recent years, national guidelines have recommended against prostate cancer screening. We sought to determine if prostate biopsy incidence has changed over time in Ontario. We hypothesized that there has been a decrease in the incidence of prostate biopsy in recent years. METHODS: This cohort study used population-based administrative databases from Ontario, Canada. We used a diagnostic code to identify if a patient received his first prostate biopsy between 1992 and 2012 (the last year for which records in the Ontario Cancer Registry were complete). Age-stratified and overall age-standardized incidences of prostate biopsy were determined. Changes over time in prostate biopsy incidence and the proportion of prostate biopsies that showed malignant disease were examined using negative binomial regression adjusting for patient age. RESULTS: We identified 231 266 Ontario men aged 40 years and older who received their first prostate biopsy between 1992 and 2014. Up to 2007, biopsy incidence increased in younger men, but decreased in older men. After 2007, biopsy incidence decreased in all age groups, with the age-standardized overall biopsy incidence dropping from 480 per 100 000 in 2007 to 250 per 100 000 in 2014. A total of 84 149 (39%) incident biopsies showed malignant disease. The proportion of biopsies classified as showing malignant disease increased during the study period, from 25.6% in 1992 to 49.2% in 2010, and then decreased in all age groups. INTERPRETATION: Previously increasing biopsy rates decreased significantly in recent years, suggesting that prostate cancer screening in Ontario may be changing.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: yes | Observational | low |
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) | 0.001 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".