Reply to: Correction for length bias reduces the mortality benefit from hepatocellular carcinoma surveillance

quickly. This heterogeneity emphasises the importance of and the development of methods to adjust for it warrant greater 'slower growing tumours'5 may not exactly reflect the underlying proportions in the included studies with our estimate drawn from a large meta-analysis of diverse cohorts. In addition, the values of relative mortality of fast and slow growing tumours lack a strong empirical basis and were chosen due to their inclusion in an earlier analysis.4 It is possible that this relative mortality could be lower than estimated, given However, this would only increase the effect of length bias.

Automated summary

The heterogeneity in the impact of tumor growth rate on mortality highlights the need for methods to adjust for it. The estimation of the proportions of slow growing tumors may not accurately represent the underlying data due to the inclusion of diverse cohorts in the study. The values of relative mortality for fast and slow growing tumors lack empirical basis and were chosen based on a previous analysis.