Risk of Colorectal Cancer after Diagnosis of Endometrial Cancers: A Population-Based Study: ACG/Naomi Nakao Gender-Based Research Award
Bibliographic record
Abstract
Purpose: We aimed to determine site specific risk of colorectal cancer (CRC) among survivors of endometrial cancers of different age groups, so as to guide recommendations for CRC screening among survivors of endometrial cancers. Methods: We conducted a historical cohort study by linking several large longitudinal databases routinely collected in Manitoba, including the the Manitoba Cancer Registry and some of Manitoba Health databases. Each subject diagnosed with endometrial cancer as their first cancer (cancer cohort) between 1987 and 2008 was age matched with up to five individuals with no history of invasive cancer (control cohort) on the index date (date of diagnosis of endometrial cancer in the cancer cohort). All study subjects were followed up to the date of diagnosis of CRC or another primary invasive cancer of any type, death, migration out of the province, or study end-point (December 31, 2009), whichever came first. Competing risk proportional hazard models were used to calculate the relative risk (estimated by hazards ratio (HR)) and 95% confidence intervals (CI) contrasting CRC incidence rates among the cancer and control cohorts. The analysis had three mutually exclusive (and competing) outcomes including diagnosis of CRC and was adjusted for age, history of lower gastrointestinal endoscopy and socioeconomic status. Results: 3,115 women with endometrial cancer and 15,084 controls were followed up for a total of 145,502 person years. Women diagnosed with endometrial cancer at age less than 50 had a marked increased risk of being diagnosed with CRC (all CRC: HR 4.4; 95% CI 1.14-13.26. Right-sided CRC HR 6.70; 95% CI 1.29-43.28). The increased risk persisted in these subjects for follow-up beyond 50 years of age. There was no increased CRC risk among women aged 50-65 or older than 65 at time of diagnosis of endometrial cancer. Conclusion: This study suggests there is an increased risk of CRC after diagnosis of an endometrial cancer among young women. Such subjects need follow-up in particular for right-sided CRC.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 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".