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Incapsula incident ID: 348000730168256819-287241820731871822

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Modelling cannot produce evidence: all models require some assumption about a mortality reduction from screening or must infer benefit from a surrogate observation (eg, stage shift).48 Non-randomised evidence should be ignored as such comparisons are vulnerable to prevention bias49: people who choose to be screened are systematically healthier than those who are not screened.50 Finally, policy makers have an ethical imperative to hold screening to the highest evidence standard