A retrospective analysis of the role of proton pump inhibitors on colorectal cancer disease survival.
Bibliographic record
Abstract
e14517 Background: Proton pump inhibitors (PPI) are one of the most commonly used medications. A limited number of studies have identified a weak-to-moderate association between PPI use and colorectal cancer (CRC) risk but none to date have identified an effect of PPI on CRC survival. Methods: To identify a potential association between PPI and colorectal cancer survival, we performed a retrospective chart review of CRC patients treated at the Cancer Center of Southeastern Ontario diagnosed from January 2005 to December 2011. 1304 colorectal cancer patient charts were identified through Ontario Cancer Registry Data based on confirmed ICD-10 diagnosis codes and patient, tumor and treatment variables were extracted into the database. Results: Preliminary analysis indicated that 117 (9.0%) patients were using PPIs at the time of oncology consult. Those on PPI were more often on ASA (38.5% vs 19.3%, p < 0.0001) and statins (38.5% vs 23.3%, p = 0.0005) and were found have a statistically significantly higher rate of cardiac disease (78.6% vs 57.4%, p < 0.0001). There was no identifiable difference in the tumor characteristics between the 2 groups, including tumor location, differentiation, lymph node status and stage. Univariate analysis identified a non-statistically significant difference in survival with those on PPI having a decrease in 1, 2 and 5 yr OS (Table). Multivariate Cox regression analysis, when taking into account patient demographics (sex, age, comorbidities, BMI, smoking and alcohol history) and tumor characteristics (including stage, differentiation and nodal status) identified a statistically significant effect of PPI on risk of dying in our patient population (HR = 1.350, C.I 1.006-1.813, p = 0.046). Conclusions: Taken together, our work suggests a potential adverse effect of PPI on overall survival of colorectal cancer patients. PPIs # of Deaths N (%) 1 yr OS % (p-value) 2 yr OS % (p-value) 5 yr OS % (p-value) No 451/1187 (38.0) 86.7 (ref) 76.8 (ref) 62.9 (ref) Yes 55/117 (47.0) 82.1 (0.161) 70.1 (0.111) 55.2 (0.1651)
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| 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) | 0.002 | 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".