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> we need studies that show that the screening improves outcomes.

I would be wary of a study conflating screening with outcomes — that is unnecessarily coupling too many factors. [1]

The screening isn’t an intervention, so why would it make sense to study its effects on an outcome? Those effects are indirect, mediated by the causal factors of the choice of treatment.

Am I missing something?

Perhaps you are looking for psychological effects of getting an early test?

[1] Treatment outcomes depend on the current state of technology and the practice of medicine.



Because screening leads to interventions when it is the data used for deciding whether to do an intervention.

If a screening procedure leads only to interventions that would be made in time anyway, it doesn't provide a benefit.

If it leads to extra interventions and no drop in mortality, it may be a net negative.

E.g irradiate enough people to find more cancers and not improve outcomes, and some of your screening may lead to cancers.




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