Temporal trends in health status among adults in the Childhood Cancer Survivor Study (CCSS).
Bibliographic record
Abstract
10020 Background: The impact of temporal changes in childhood cancer therapy on long-term health status has not been evaluated. With expansion of CCSS, information about health status is available for 5+ year survivors diagnosed from 1970-1999. Methods: We estimated prevalence of poor general and mental health, functional impairment, activity limitation and cancer-related anxiety and pain at baseline evaluation among 15,830 survivors of childhood cancer. Outcomes were compared among treatment decades using log-binomial regression to calculate relative risk (RR) and 95% confidence interval (CI), adjusted for age, sex, race and diagnosis. Results: Proportions of survivors treated with radiation and amputation decreased; proportions treated with anthracyclines or alkylating agents increased over time. Survivors diagnosed more recently were more likely to report poor general health, pain and anxiety, and less likely to report functional impairment. Diagnoses with large increases (p < 0.001) in prevalence of adverse outcomes from 1970-79 to 1990-99 were leukemia (9.8 to 12.6% poor general health), bone tumor (23.2 to 30.7% pain) and Hodgkin lymphoma (15.7 to 19.2% anxiety). CNS tumor survivors had the largest decrease in functional impairment prevalence (37.7 to 19.7%). Conclusions: While the proportion of childhood cancer survivors reporting functional impairment in the most recent era decreased, particularly among CNS tumor survivors, proportions reporting poor general health, pain and anxiety increased slightly from 1970 to 1999. 1970-79 1980-89 1990-99 Median (Range) Diagnosis age (years) 8 (0-21) 11 (0-21) 10 (0-21) Age at evaluation 28 (18-48) 26 (18-48) 26 (18-42) % Male 52.4 53.4 50.6 White 89.0 83.9 76.2 Cranial radiation 33.1 24.4 12.4 Chest radiation 24.2 20.0 9.9 Amputation 5.4 4.5 1.7 Alkylating agent 27.4 59.9 58.4 Anthracycline 30.7 51.4 59.3 Mean dose (mg/m2) 335 ± 284 271 ± 144 214 ± 118 RR (95% CI) Poor general health 1.0 1.1 (1.0-1.2) 1.2 (1.1-1.3) Functional impairment 1.0 (0.9-1.1) 0.8 (0.7-0.9) Activity limitation 0.9 (0.8-1.0) 0.9 (0.8-1.0) Poor mental health 1.0 (0.9-1.1) 1.0 (0.9-1.1) Pain 1.1 (1.0-1.2) 1.2 (1.1-1.4) Anxiety 1.1 (1.0-1.3) 1.2 (1.1-1.3) *p-values for trend < 0.001.
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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 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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, 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".