Refusal of colorectal cancer surgery in the United States: Predictors and associated cancer-specific mortality in a Surveillance, Epidemiology, and End Results (SEER) cohort
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
INTRODUCTION: This study aims to understand patient factors associated with refusal of surgery for nonmetastatic colorectal cancer and the associated cancer-specific mortality. METHODS: Patients diagnosed with nonmetastatic colorectal cancer between 2004 and 2015 from the Surveillance, Epidemiology, and End Results Program were included. RESULTS: A total of 152,731 (99.4%) patients underwent surgery, and 983 (0.6%) refused surgery. Independent predictors of refusal included male sex, older age, minority race, single relationship status, being uninsured, more recent date of diagnosis, having an earlier stage of diagnosis, and rectal versus colon cancer. Refusing surgery for nonmetastatic colorectal cancer increased cancer-specific mortality (adjusted hazard ratio 5.10, 95% confidence interval 4.62-5.62). CONCLUSION: Most patients diagnosed with nonmetastatic colorectal cancer undergo surgery in the United States. However, refusal of surgery is increasing and associated with higher cancer-specific mortality. A better understanding of surgical decision making in colorectal cancer is urgently needed.
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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 | 0.011 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.004 |
| Science and technology studies | 0.000 | 0.002 |
| 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 it