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This may be an extreme underestimation.
The frequency of secondary neoplasia in 1 of 294 participants is probably an extreme underestimation of the true frequency due to a relatively short follow-up.
It's an extreme rivalry".
She is an extreme minimalist.
It is an extreme case.
"It is an extreme danger".
California is an extreme instance.
Russia is an extreme example.
It's an extreme sport.
That is an extreme position.
Kansas is an extreme example.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com