A163 CATCHING CANCERS EARLY? AGE AND STAGE AT DIAGNOSIS OF COLORECTAL CANCER IN FIRST NATIONS PEOPLE IN ONTARIO COMARED TO OTHER ONTARIANS
Bibliographic record
Abstract
Abstract Background Historically, Indigenous peoples in Canada were at lower risk for cancer compared to non-Indigenous people. Data from prior to 2010 suggested that First Nations in Ontario had higher incidence & poorer survival from colorectal cancer (CRC). The current project arose from concerns raised by Indigenous partners about community members being diagnosed with colorectal cancer before screening age-eligibility. Aims To examine the age & stage at CRC diagnosis among First Nations people in Ontario (FN) compared to other Ontarians (ON). Methods With Indigenous partner support, approvals were obtained to link health administrative datasets at ICES & Ontario Health. Among others, these datasets included the Ontario Cancer Registry & the Indian Register System, a registry of FN with status, meaning they are on the official record of persons registered under section 6 of Canada’s Indian Act. We created cohorts of FN & ON aged 18-85 from 2000 to 2018, matched 1:5 on sex, age at & year of inception. For the primary analysis, we performed survival analysis, accounting for the competing event of death & using attained age as a time scale. The primary outcome was CRC diagnosis, the primary exposure was FN vs ON & we adjusted for regular screening test use, comorbidity, remoteness & having a regular primary care provider. Similarly, we examined stage at diagnosis, restricting the cohort to 2007+ due to limitations in the stage data. Results Baseline demographics for the 153,300 FN & 766,500 ON included are in the Table. Median (IQR) follow-up was 17 (8-20) & 18 (I8-20) years for FN & ON, respectively (p ampersand:003C0.001). There were 1,156 (0.8%) & 4,249 (0.6%) CRCs diagnosed in FN & ON, respectively (p ampersand:003C0.001). 11,213 (7.3%) FN & 25,732 (3.4%) ON died from other causes (p ampersand:003C0.001). After accounting for the competing event of death, FN were significantly more likely to be diagnosed with CRC at a younger age (HR 1.42, 95%CI: 1.32-1.53) (see Figure) & later stage (HR 1.53, 95%CI: 1.34-1.75) than ON. Conclusions FN with CRC were younger & presented at a later stage compared to ON with CRC. These findings have important implications for CRC screening recommendations for First Nations people in Ontario. Baseline characteristics at cohorts inception IQR, interquartile range A. Cumulative incidence of colorectal cancer (primary event) & death (competing event), comparing First Nations (FN) and other Ontarians (ON). B. Focus on cumulative incidence of colorectal cancer (death as competing event, not shown), comparing FN and ON. Funding Agencies CIHR
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".