We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

The Swedish Prostate Cancer Paradox

Patrick C. Walsh, MD; James D. Brooks, MD
JAMA. 1997;277(6):497-498. doi:10.1001/jama.1997.03540300065036.
Text Size: A A A
Published online


In this issue of THE JOURNAL, investigators from Sweden present their 15-year results of expectant management of prostate cancer.1 They conclude that localized prostate cancer has a favorable outlook following watchful waiting and that the number of deaths potentially avoidable by initial radical treatment is limited. These results sound encouraging and suggest that the aggressive approach to early diagnosis and therapy currently used by many physicians in the United States may constitute overtreatment. However, prostate cancer is far from being a benign disease in Sweden. Sweden has the fourth-highest age-adjusted mortality rate from prostate cancer in the world, 21% higher than the United States, which ranks 13th.2 This article thus presents a conundrum: if watchful waiting in localized disease results in few deaths, why is the overall mortality from prostate cancer in Sweden high?

See also p 467.

In the 223 cases of localized prostate cancer managed with


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.