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Fifteen-Year Survival With Prostate Cancer in Sweden-Reply

Johansson Jan-Erik, MD, PhD; Lars Holmberg, MD, PhD; Reinhold Bergström, PhD; Adami Hans-Olov, MD, PhD; Sara Johansson
JAMA. 1997;278(3):206. doi:10.1001/jama.1997.03550030046030.
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In Reply.  —Drs Aus and Hugosson claim that we have underascertained deaths due to prostate cancer in our study. Their concern is based on a rather cavalier approach to epidemiological methods; they attempt to validate the mortality data we reported in a closed cohort study by means of cross-sectional data from the entire population.It is well established,1 and further demonstrated in our article that patients with prostate cancer have excess mortality during many years. Hence, mortality rates during the 18-year period 1977 through 1994 are generated by 3 distinguishable cohorts of patients, namely, those who developed prostate cancer (1) during a number of years prior to 1977; (2) between 1977 and 1983 (those who were clinically diagnosed are included in our study cohort); and (3) between 1984 and 1994.Aus and Hugosson apparently overlook the need to separate mortality generated by our incidence cohort from that among prevalent cases in


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