Congruence of cancer screening recommendations between the USPSTF and the top ten US cancer centers: a cross sectional study
Bibliographic record
Abstract
Background: The United States Preventive Services Task Force (USPSTF) is an independent volunteer organization of multi-disciplinary national experts in disease prevention that publishes evidence-based guidelines for cancer screening. However, these guidelines are not binding and many individual cancer centers publish their own screening recommendations. Methods: This cross-sectional study compared the congruence of cancer screening recommendations between the USPSTF and the Top Ten US Cancer Centers as per the U.S News and World Report 2022-2023 for colorectal (CRC), lung (LC), cervical (CC), prostate (PC), and breast cancers (BC) in average risk patients. The evaluated variables included screening tests, recommendation direction, strength, frequency, age of start, age of end, and discussion/quantification of risks and benefits. Findings: Our study identified substantial variability between the screening recommendations from the Top Ten US Cancer Centers and the evidence based USPSTF guidelines for BC, PC, and CC. The discordance was almost always in the direction of the cancer centers recommending more screening beyond the USPSTF's recommendations, and without discussion of potential risks and harms. For LC and CRC, the guidelines were generally concordant between the cancer centers and USPSTF. Interpretation: Top Ten US Cancer Centers make screening recommendations inconsistent with those of the USPSTF recommendations, with cancer centers generally recommending more screening and omitting a nuanced discussion of benefits and risks. Given the national and international reputation of these cancer centers, their recommendations can have important population level implications, including confusion in the public. Funding: None.
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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 | 0.030 | 0.081 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 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".