Evidence map›Paper›PMID 41335397›Full record

ArticleEuropean journal of epidemiology2025

Choosing a sensible contrast makes "prevalence bias" irrelevant in screening colonoscopy trials.

Marco Piccininni, Vanessa Didelez, Mats J Stensrud

Abstract read
In one paragraph

Article in European journal of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Marco PiccininniInstitute of Mathematics, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
Vanessa DidelezLeibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Mats J StensrudInstitute of Mathematics, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland. mats.stensrud@epfl.ch.ORCID http://orcid.org/0000-0001-9641-1936

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Screening colonoscopy has been shown to reduce colorectal cancer incidence. However, the magnitude of this effect is debated. There is concern that some trial participants already had colorectal cancer at baseline. The screening procedure could not prevent disease occurrence in these participants, leading to "prevalence bias". Some authors have argued that the effect of interest is confined to participants without disease at baseline, and failing to exclude prevalent cases supposedly leads to effect underestimation. Yet, the issue is debated, with other authors arguing that conventional randomized trials provide the effects that are most relevant to public health. Here we present new, formal arguments that clarify misconceptions in this debate. We show that, under mild assumptions, the so-called "prevalence bias" is not a concern when researchers are interested in estimating risk differences, rather than risk ratios. This is because of a statistical property of the causal risk difference when outcomes are rare, called "doomed-selection stability".

Indexed as

ColonoscopyColorectal NeoplasmsEarly Detection of CancerMass ScreeningRandomized Controlled Trials as TopicBiasHumansPrevalenceEffect heterogeneityPrevalence biasRisk ratioScreening colonoscopy

Identifiers

PMID41335397
PMCPMC12695937

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.