P150 High adherence to surveillance guidelines in IBD results in low CRC and dysplasia rates, while rates of dysplasia and cancer are low before the suggested start of surveillance. Results from a tertiary IBD centre
Bibliographic record
Abstract
Patients with Crohn’s disease(CD) and ulcerative colitis(UC) are at increased risk for colorectal dysplasia (CRD) and cancer (CRC). Adherence to CRC surveillance guidelines is reported to be low internationally. Our aim was to evaluate surveillance practices at the tertiary IBD Center of the McGill University Health Center (MUHC) and to determine CRD/CRC incidence rates. A representative IBD cohort with at least 8 years of disease duration (or with PSC) who visited the MUHC between 1 July and 31 December 2016 were included. Adherence to surveillance guidelines was compared with modified 2010 BSG guidelines. Incidence of CRC, high-grade dysplasia (HGD), low-grade dysplasia (LGD) and colorectal adenomas (CRA) were calculated based on pathology reports. In total, 1356 CD and UC patients (disease duration: 12 (IQR: 6–22) and 10 (IQR: 5–19) years) were identified. The surveillance cohort consisted of 689 patients (296 UC and 384 CD). 91.5% of patients had at least one surveillance colonoscopy. Adherence to surveillance guidelines was 75.6/82.1% in UC/colonic CD. Adequate number of biopsies were taken in 53.7/54.2% of UC/colonic CD patients. Incidence of CRC/HGD in UC and CD with colonic involvement was 19.5/58.5 and 25.1/37.6 per 100000 patient-years. Incidence of dysplasia before 8 years of disease duration was low in both UC/CD (19.5 and 12.5/100000 patient-years) with no patients developing CRC. The CRA rate was 30/38% in UC/colonic CD. High adherence with surveillance guidelines and overall low CRC and dysplasia, but not CRA rates were found in the screened population, suggesting that meeting updated, stratified, surveillance recommendations may result in low advanced neoplasia rates. CRC and dysplasia rates incidentally detected before the suggested start of the surveillance were low.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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) | 0.000 | 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".