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December 9, 1992

Cancer of the Prostate-Reply

Author Affiliations

Örebro Medical Center Hospital
Uppsala University Sweden

JAMA. 1992;268(22):3199-3200. doi:10.1001/jama.1992.03490220040019

In Reply.  —We are well aware that our results challenge the value of a surgical procedure that many think is the treatment of choice, and that they are thus controversial.Dr Catalona is eager to explain away the fact that we traced every incident case of the disease in a strictly defined area and subjected them to complete, extensive, and standardized long-term follow-up, which included measurements of serum acid phosphatase. He also fails to recognize that experimental methods need proper scientific assessment in clinical trials before they are implemented in general practice.The present article and a previous one1 show unequivocally that age at diagnosis is not an important determinant in our population of disease progression and death in prostate cancer. The age mix of the patients is therefore not an issue; individuals are followed until they die from intercurrent diseases and cannot further influence estimates of progression, relative