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No One Dies From Prostate Cancer?—Reply
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In reply
Chau's main comment about seeking data less than 10 years old appears to confuse our case-control analysis1 with an observational cohort study design. Specifically, the deficit of screening among case patients who died "early" is the crux of our results; men with long-term survival benefit, after being screened and treated, are represented in the control group who lived. In addition, it's virtually impossible to obtain relevant data in less than 10 years for an outcome (mortality in prostate cancer) measured typically over a 10- to 15-year interval. When results from the eagerly anticipated randomized trials2-3 of screening for prostate cancer become available in the next few years, will they be similarly criticized for enrolling patients in the mid-1990s?
The letter also places unwarranted emphasis on "numerous landmark studies," implying a recent revolutionary change in medical care. Although medical progress has occurred in the past 10 years, most diseases . . . [Full Text of this Article]
AUTHOR INFORMATION
John Concato, MD, MS, MPH;
Carolyn K. Wells, MPH
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