A Cohort Study Analysing the Impact of the COVID-19 Pandemic on Colorectal Cancer Presentations in a Medium-Large Canadian Community Hospital
Why this work is in the frame
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Bibliographic record
Abstract
Introduction Colorectal Cancer (CrC) is a common cause of cancer-related death worldwide, but screening programs are highly effective at diagnosing early-stage disease, allowing effective treatment. During COVID-19, a decrease in screening participation was hypothesized due to limited access, leading to an increase in symptomatic presentations and stage at diagnosis. Methods All patients who met inclusion criteria were divided into two cohorts based on time of diagnosis ( n = 373). The pre-COVID era was designated as December 2018 to February of 2020, with the COVID era running from then until March 2021. All patients were from the Windsor Regional Hospital Cancer Centre, located in Windsor, Canada. Results Across time periods, 218 patients were diagnosed prior to, and only 144 during COVID. The number of Fecal Immunochemical Test (FIT) positive patients remained stable, while the number of procedural diagnoses decreased from 34.1% to 10.7%, with only 21.2% of patients overall being diagnosed with screening. When combining time periods, females presented symptomatically (85.0%) more often than males (74.4%). Patients with a positive family history were more likely to be diagnosed via procedural screening (42.9%) than those without (20.4%). Conclusion There was no change to the proportion of symptomatic presentations across time groups, in contrast to our predicted outcome. There was a decrease in procedural screening during the COVID timeframe, with FIT testing rates remaining stable, likely representing patients being transferred to available methods. Female patients and patients with a family history demonstrated a particular need for increased screening participation based on our findings.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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