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Mark E. Cowen, MD
University of Michigan Medical School Ann Arbor

Michael W. Kattan, PhD; Brian J. Miles, MD
Baylor College of Medicine Houston, Tex

JAMA. 1996;275(1):31-32.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The medical community should focus on how the study by Dr Albertsen and colleagues¹ translates into clinical practice, ie, what information it provides for a patient deciding on treatment options today. Our first concern is how applicable these findings are to today's patient with localized prostate cancer. Although a population-based study tends to minimize selection bias, the authors did not study all men with clinically localized disease, only those managed conservatively. In the absence of a reference group (in this case, patients treated with surgery or radiation therapy), the authors chose a general population estimate of life expectancy. They report only the historical survival of selected patients who had opted, for unspecified reasons, for conservative management. Today's clinician and patient, therefore, cannot use this information to compare the expected survival with or without treatment.

Second, it is not known if tumors identified in the 1970s are . . . [Full Text PDF of this Article]

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