Survival and mortality of elderly men with localized prostate cancer managed with primary androgen deprivation therapy or by primary observation

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Boström, Karri Seppä, Janne Pitkäniemi, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.13155/v3 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 12 Mar, 2020 Read the published version in BMC Urology → Version 3 posted 4 You are reading this latest preprint version Show more versions Abstract Background: Androgen deprivation therapy (ADT) remains a primary treatment for localized prostate cancer (PCa) even though there is no evidence that its use is beneficial in the absence of curative treatment. Methods: Men aged ≥70 years ( n = 16534) diagnosed with localized PCa from 1985 to 2014 and managed either with primary observation or ADT in the absence of curative treatment were included. The cases were identified from the population-based Finnish Cancer Registry. We estimated the standardized mortality ratios (SMR) for overall mortality by treatment group. We determined the relative risk (RR) of PCa-specific mortality (PCSM) and other-cause mortality between the two treatment groups. Survival was determined using the life table method. Two age groups (70–79 years and ≥80 years) and three calendar time cohorts (1985–1994, 1995–2004, and 2005–2014) were compared following adjustment of propensity score matching between the treatment groups with four covariates (age, year of diagnosis, educational level, and hospital district). Follow-up continued until death or until December 31, 2015. Results: Patients in the observation group had lower overall SMRs than those in the ADT group in both age cohorts over the entire study period. PCSM was higher in men aged 70–79 years undergoing primary ADT compared to those managed by observation only (RR: 1.70, 95% confidence interval [CI]: 1.29–2.23 [1985–1994]; RR 1.55, 95% CI: 1.35–1.84 [1995–2004]; and RR 2.71, 95% CI: 2.08–3.53 [2005–2014]); p = 0.005 for periodic trend. A similar trend over time was also observed in men aged >80 years; ( p for age–period interaction = 0.237). Overall survival was also higher among men in their 70’s managed by observation compared to those undergoing ADT. Conclusions: Primary ADT within four months period from diagnosis is not associated with improved long-term overall survival or decreased PCSM compared to primary conservative management for men with localized PCa. However, this observational study’s conclusions should be weighted with confounding factors related to cancer aggressiveness and comorbidities. Oncology Prostate cancer survival Prostate cancer–specific mortality Localized prostate cancer Androgen deprivation therapy Figures Figure 1 Background Androgen deprivation therapy (ADT) has been the cornerstone of treatment for locally advanced and metastatic (M+) prostate cancer (PCa) since the 1940s [1]. Immediate ADT or ADT combined with docetaxel or abiraterone acetate is the current treatment of choice for M+ PCa [2]. However, the use of ADT increased sharply between 1989 and 2001 in the USA despite the fact that ≤5% of patients with newly diagnosed PCa have distant metastases at first presentation compared with 20–25% ≥20 years ago [3, 4]. While the increased use of ADT is partly accounted for by the uptake of neoadjuvant and adjuvant treatment along with radiation therapy, it is primarily elucidated by ADT for localized disease, especially for elderly patients [5]. Thus, ADT is commonly used to treat localized PCa although it has not been shown to improve survival [6]. The risk of metastases or death from conservatively managed clinical stage T1/T2 cancers was estimated in a meta-analysis of six studies from the era prior to prostate-specific antigen (PSA) [7]. The risk of metastasis at 10 years was found to be 19%, 42%, and 74% for well-differentiated, moderately differentiated, and poorly differentiated tumors, respectively [7]. Similarly, the long-term clinical outcomes of localized PCa without initial treatment with curative intent during the PSA era were assessed [8]. Thirty per cent of the patients died of PCa and 30% of other causes within a 12-year period [8]. A landmark Swedish study demonstrated a benign course of well- or intermediately differentiated PCa in the absence of initial treatment with curative intent [9]. Thus, the clinical course of localized high-risk PCa can be progressive, but the majority of cancers are indolent and slow to progress [2]. According to current guidelines, observation with the option of later treatment in the case of disease progression (i.e., watchful waiting) is recommended for localized and locally advanced PCa in elderly patients with competing comorbidities. The objective of this observational study was to investigate mortality in elderly PCa patients primarily managed with ADT or observation only during long follow-ups in Finland. Methods Study population The Finnish Cancer Registry is a nationwide population-based register of all incident cancer cases diagnosed in Finland since 1953. The health care personnel in hospitals, outpatient clinics, and healthcare facilities are obligated to notify of new cases. Additionally, pathology notifications are received from all histopathological laboratories in Finland. The registry coverage is estimated at 99% for male genital cancers [10]. The spreading into localized, locally advanced, or metastatic are classified by tumor size, regional node involvement, and presence of metastasis for cases covered by the Finnish Cancer Registry. The Finnish Cancer Registry data can be linked with the population register center database for dates of death or emigration and causes of death and education levels from Statistics Finland. We identified all PCa patients aged 70 years or older at diagnosis with localized cancer (clinical stage T1/T2) from 1985 to 2014 and managed by primary ADT or observation in the absence of radical treatment with curative intent (Table 1). Of the total patients identified ( n = 16534), 11572 were aged 70–79 years and 4962 were ≥80. Within four months of diagnosis, the primary treatment was ADT (ADT group n = 9704), while 6830 received no treatment (observation group) (Table 1). The regional data included 22 hospital districts taking care of specialized care. The survival rates of the patients were compared by age and treatment group over three periods (1985–1994, 1995–2004, and 2005–2014). Statistical analysis Overall survival was evaluated using the life table method [11]. The Poisson regression model was used to quantify differences in patient mortality between the defined groups. The results were reported as relative risk (RR) of PCa-specific mortality (PCSM) and mortality due to causes other than PCa. We also estimated the standardized mortality ratio (SMR) for overall mortality among the patients. The SMR is estimated as the ratio of observed and expected numbers of deaths. The latter was derived from the mortality rates of the male population in Finland stratified by age (1-year intervals) and calendar year. We used a nearest neighbor matching with a logistic regression–based propensity score [12] to identify a cohort of 5715 paired patients. In the logistic regression, the probability of a given treatment was modeled as a function of age and calendar period (in 5-year groups), education, and hospital district. Interactions between calendar period and each of the covariates were also included in the model. Statistical analysis was performed with R (version 3.2.3) using the packages popEpi [13] and MatchIt [14]. The study protocol was approved by the institutional review board of the Hospital District of Southwest Finland. The National Institute for Health and Welfare (Finland) approved access to the registry data (study number 182/5.05.00/2015). Statistics Finland approved access to the data on the cause of death (study number TK-53-86-17). Results The stage distribution of all prostate cancer patients from 1985 to 2014 ( n = 95959) in Finland is shown in Supplementary Table 1. Approximately half of the patients were classified as having localized PCa. The proportion of metastatic disease decreased from 28% to 17% between the periods 1985–1994 and 2005–2014. However, the PCa stage was missing in nearly one-third of the patients over the study period (Supplementary Table 1). In this study, we included only PCa patients aged 70 years or older at diagnosis who received primary treatment with ADT or no treatment within four months of diagnosis (Table 1). SMR analysis showed that overall mortality was lower in the observation group than in the ADT group in all three time periods. However, a declining trend in SMR over time was seen in both groups. Furthermore, over the most recent period (2005–2014), patients in both age cohorts had lower overall mortality than the general male population in Finland (SMR: 0.93, 95% CI: 0.88–0.98) (Table 2). Propensity score matching did not change any of these results. In both age cohorts, we observed higher PCSM in patients undergoing primary ADT compared to those managed by observation only (Table 3). The relative risk of prostate cancer mortality increased significantly over time in the ADT group compared to the observation group ( p for trend = 0.05). On the other hand, the risk of death from causes other than PCa decreased over time in patients aged 70–79 years undergoing primary ADT compared to those managed by observation only, but the same was not true in patients aged 80 years or older (Table 3). Overall survival of PCa patients aged 70–79 years was higher in the observation group than in the ADT group throughout the study period. However, a rising trend was observed in both treatment groups. Among patients over 80 years of age, overall survival improved over time in both treatment groups with no significant differences between them until the most recent period (from 2005 to 2014), when overall survival in the observation group was higher than in the ADT group (Fig. 1). The results remained similar after propensity score matching. Discussion In this population-based study, we investigated whether the survival and mortality outcomes in elderly male patients (aged ≥70 years) with localized PCa is different between those managed by primary observation and those undergoing primary ADT over a long period of time. We showed that the overall SMR of patients in the observation cohort was lower than those in the ADT cohort in both age groups over the entire study period. PCSM and mortality due to causes other than PCa were lower in patients monitored with primary observation compared to those managed with primary ADT. This difference was particularly evident in patients aged 70–79 years at the time of diagnosis. Overall survival was also higher in subjects in this age group managed by primary observation. By contrast, a smaller difference in PSCM was observed between patients undergoing ADT and those managed by primary observation, while a clear difference in mortality due to other causes was not seen in patients aged 80 or older. This implies a better general health condition and a healthier lifestyle among patients in the observation cohort. An increased risk of PCSM was observed in patients undergoing primary ADT compared to those managed by primary observation, while a lower risk of other-cause mortality was seen in the younger patient group managed by primary observation. This suggests that in recent times, primary ADT without curative treatment was generally selected for patients with aggressive disease. A 10-year threefold risk of PCSM was associated with poorly differentiated PCa among patients with conservatively managed localized PCa in the Surveillance, Epidemiology, and End Results (SEER) Program [15]. Most male patients with conservatively managed localized PCa aged >66 years with competing comorbidities died from causes other than PCa in a period of 10 years, irrespective of age and tumor aggressiveness [16]. The use of primary ADT was beneficial for patients with aggressive disease and few comorbidities [16]. However, overall mortality was lower in subjects managed by observation than with ADT. We assumed that a shift from ADT to a more radical treatment may have occurred in patients with a good general health status. Since an increasing number of PCa cases has been diagnosed in recent years, and observation is widely utilized in Finland, it is likely that observation was selected for patients with less aggressive histology and without advanced disease. Consequently, fewer male patients died of cancer owing to the slow, natural course of disease. Overall survival was reduced in patients aged 70–79 years initially treated with. It is still difficult to draw a conclusion from this finding owing to the absence of data on patient comorbidities. However, increased morbidity and mortality from ADT-related side effects is possible. Thus, the survival benefits of ADT are partly offset by its high toxicity. These findings can also be explained by a better general health condition among patients in the observation group. In our cohort, patients in the observation group had a clearly lower risk of overall mortality compared to patients undergoing primary ADT. Since in epidemiological studies the only endpoint that is free from bias is mortality, we can assume that patients in observation cohort were healthier than those in the ADT cohort. Many population-based analyses suggest that gonadotropin-releasing hormone (GnRH) agonist use is associated with a greater risk of coronary artery disease, myocardial infarction, and diabetes mellitus (DM) [17–19]. Subsequent reports have suggested that male patients with comorbidities or prior cardiovascular disease treated with GnRH agonists might be at increased risk of cardiovascular mortality [20, 21]. Based on these observations, a science advisory consensus statement on GnRH agonist therapy and cardiovascular risk was issued, together with a U.S. Food and Drug Administration safety warning to address concerns of increased risk of myocardial infarction, stroke, sudden cardiac death, and DM [22]. However, conflicting results have been reported. In a recent meta-analysis, ADT use was not associated with an increased risk of cardiovascular death, but with a lower risk of PCSM and all-cause mortality [23]. Studer et al. also reported that ADT for localized PCa may even reduce cardiovascular mortality if started immediately after diagnosis [24]. The current study findings did not support the life-prolonging effects of primary ADT for localized PCa. Several reports have shown similar results: In a prior population-based cohort study on 66717 Medicare patients diagnosed between 1992 and 2009, and who received no definitive local therapy within 180 days of prostate cancer diagnosis, primary ADT was not associated with improved overall long-term CSS or the CSS of patients with localized PCa [25]. Instead, there is evidence that primary ADT led to inferior outcomes [24]. Low overall survival rates were reported for male patients with localized disease treated with primary ADT rather than observation in a previous population-based study [26]. In addition, Potosky et al. reported that primary ADT was neither associated with an enhanced risk of all-cause mortality (hazard ratio [HR] of 1.04, 95% CI: 0.97–1.11) nor PCa-specific mortality (HR of 1.03; 95% CI: 0.89–1.19) after adjusting for the sociodemographic and clinical characteristics of patients with localized PCa. However, primary ADT was associated with a decreased risk of all-cause mortality, but not PCSM, among patients at high risk of PCa progression [27]. PSA screening practices have increased exponentially over a 30-year period, and regular PSA testing is used frequently among all socioeconomic groups in Scandinavia and Finland [28, 29]. In the early years of the present study, a diagnosis of localized PCa was generally performed via a digital rectal examination or using pathological specimens obtained following a transurethral resection of the prostate. In recent years, most localized PCa cases have been diagnosed by prostate biopsies prompted by elevated PSA values. Moreover, although a proven benefit of the PSA screening of older males has not been shown, PSA testing is frequently performed for elderly patients [30]. The wide-stage migration of PCa from advanced to indolent disease has been reported over ≥20 years [31]. Thus, a commonly employed but poorly organized screening policy explains the increased rate of PCa in past decades in Finland. Consequently, the number of elderly male patients with PCa has also increased. This implies that the more favorable outcomes associated with the use of primary observation compared to ADT in patients with PCa, especially those in their 70s, can be attributed to PSA-related “lead time” rather than life extension. Over the study period, staging of metastatic disease in Finland was performed by bone scan examination according to national guidelines until the mid-2000s, after which low-risk PCa patients typically underwent no imaging. The proportion of de novo metastatic PCa in Finland was nearly one-third from 1985 to 1994. This implies that staging procedures of PCa by bone scans were widely performed even in the earlier years of the study period, suggesting a good quality of the TNM classification data of PCa in the Finnish Cancer Registry database. In the Finnish Cancer Registry reports, the proportion of de novo metastatic PCa has recently been around 17%, higher than in Sweden [32], where the incidence of PCa is high and PSA screening is widely performed. This might also indicate a more aggressive PCa histology in cases that are classified as localized by the TNM system, and thus more commonly treated with immediate ADT than cases with less aggressive histology. A few points are worthy of further consideration. As information on patient comorbidities and detailed PCa characteristics (i.e., Gleason scores and PSA values) was not collected, it was not possible to adjust for differences in morbidity and mortality with a potential link to ADT. Thus, a comparison of study outcomes in terms of PCSM and overall survival between the different groups was not possible. Also, due to the absence of data on patient comorbidities and PCa characteristics, it was not possible to determine who would benefit from primary ADT in localized PCa. However, propensity score matching, particularly when applied to socioeconomic status/education level, may have mitigated some of the comorbidity-related limitations. Detailed information on cancer treatment was also incomplete for both treatment groups. Although men in the observation group did not receive ADT or radical treatment in the four months following diagnosis, it is conceivable that some of them may have received treatment later. This limitation may have had a substantial effect on the study outcomes. Furthermore, although the study population included patients with localized PCa, the reliability of the staging procedures over time is debatable. TNM staging was based on mandatory reports obtained from hospitals and pathological laboratories. In other words, clinical practices in Finland were governed by national and/or European prostate cancer guidelines of the time. Consequently, the risk of metastases was evaluated according to these guidelines. Notwithstanding these limitations, the study had several strengths. It was an observational population-based study estimating trends in cancer survival and mortality over time. While we did not directly compare different types of cancer treatments, population-based cohorts yield important information about PCa treatment in real-life situations, as the populations in randomized controlled trials are selected using stringent criteria by excluding out substantial proportion of real-life patients. However, in population-based studies patients are also allocated to different treatments, and results based on those can be subject to errors when comorbidities are involved. From an epidemiological perspective, these data determine the Finnish results obtained for patients managed with primary ADT or by observation. This study was based on nationwide data for PCa and included nearly 100% of patients in Finland over a nearly 30-year period. No previous population-based results from Finland on this subject have been published. Similar complete population-based coverage is not available in many European countries. Conclusion Primary ADT within four months period from diagnosis is not associated with improved long-term overall survival or decreased PCSM than primary conservative management for men with localized PCa. However, the study’s results may have been affected by patient selection or treatment intention general health and healthcare service–related factors. Declarations Ethics approval and consent to participate: The study protocol was approved by the institutional review board of the Hospital District of Southwest Finland (Study number: ETMK:116/1802/2014). The National Institute for Health and Welfare (Finland) approved access to the registry data (study number 182/5.05.00/2015). Statistics Finland approved access to the data on the cause of death (study number TK-53-86-17). Consent for publication: Not applicable. Availability of data and materials: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests: The authors declare that they have no competing interests. Funding: None. Authors’ contributions: AK, PB, NM, and JP designed the study. HS and KS performed the data acquisition. KS, HS, and JP analyzed and interpreted the data regarding prostate cancer and androgen deprivation therapy. HS, AK, and NM wrote the manuscript draft. AK, NM, JP, and PB revised the text for important intellectual content. AK, PB, and NM supervised the work. All authors read and approved the final manuscript. Acknowledgements: Not applicable. Abbreviations ADT = androgen deprivation therapy PCa = prostate cancer RR = relative risk PCSM = prostate cancer–specific mortality SMR = standardized mortality ratio References Huggins C, Stevens R, Hodges C. Studies on prostatic cancer: II. 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Tables Table 1 Study population of prostate cancer patients All patients ADT Observation Variable N % N % Age at diagnosis 70–74 3096 31.9 2850 41.7 75–79 3411 35.2 2215 32.4 80–84 2170 22.4 1227 18.0 85–89 832 8.6 438 6.4 >90 195 2.0 100 1.5 Total 9704 100 6830 100 Year of diagnosis 1985–1989 785 8.1 208 3.0 1990–1994 1197 12.3 337 4.9 1995–1999 1724 17.8 797 11.7 2000–2004 2159 22.2 1313 19.2 2005–2009 2280 23.5 2194 32.1 2010–2014 1559 16.1 1981 29.0 Total 9704 100 6830 100 Education level Basic 6920 71.3 4421 64.7 Secondary 1325 13.7 1074 15.7 High 1459 15.0 1335 19.5 Total 9704 100 6830 100 Hospital district Uusimaa 932 9.6 786 11.5 Helsinki 812 8.4 698 10.2 Varsinais-Suomi 835 8.6 628 9.2 Satakunta 500 5.2 281 4.1 Kanta-Hame 471 4.9 322 4.7 Pirkanmaa 1187 12.2 614 9.0 Paijat-Hame 668 6.9 304 4.5 Kymenlaakso 433 4.5 182 2.7 Etela-Karjala 321 3.3 179 2.6 Etela-Savo 158 1.6 102 1.5 Ita-Savo 76 0.8 64 0.9 Pohjois-Karjala 149 1.5 178 2.6 Pohjois-Savo 466 4.8 403 5.9 Keski-Suomi 374 3.9 557 8.2 Etela-Pohjanmaa 522 5.4 386 5.7 Vaasa 285 2.9 182 2.7 Keski-Pohjanmaa 136 1.4 128 1.9 Pohjois-Pohjanmaa 610 6.3 372 5.4 Kainuu 265 2.7 99 1.4 Lansi-Pohja 280 2.9 132 1.9 Lappi 190 2.0 177 2.6 Åland 34 0.4 56 0.8 Total 9704 100 6830 100 ADT = androgen deprivation therapy; N = number Table 2 Overall mortality of the study patients compared to that of the male population of Finland. Period All patients 1985–1994 1995–2004 2005–2014 ADT Observation ADT Observation ADT Observation Age SMR (95% confidence interval) All (>70) 1.48 (1.41–1.54) 1.20 (1.10–1.30) 1.19 (1.15–1.23) 1.03 (0.98–1.08) 1.08 (1.03–1.13) 0.93 (0.88–0.98) 70–79 1.57 (1.48–1.65) 1.17 (1.05–1.30) 1.24 (1.19–1.29) 1.05 (0.99–1.11) 1.11 (1.04– 1.19) 0.95 (0.88–1.01) ≥ 80 1.39 (1.22– 1.42) 1.25 (1.08–1.43) 1.10 (1.04–1.17) 1.00 (0.92–1.09) 1.04 (0.97–1.11) 0.89 (0.82–0.97) Matched pairs All (>70) 1.50 (1.38–1.63) 1.19 (1.09–1.30) 1.19 (1.13–1.25) 1.03 (0.98–1.08) 1.09 (1.03–1.15) 0.93 (0.87–0.98) 70–79 1.57 (1.41–1.74) 1.16 (1.04–1.29) 1.23 (1.16– 1.30) 1.05 (0.99–1.11) 1.12 (1.05–1.20) 0.94 (0.87–1.01) ≥ 80 1.39 (1.21– 1.60) 1.25 (1.08–1.44) 1.12 (1.02–1.21) 1.00 (0.91–1.08) 1.03 (0.94– 1.12) 0.91 (0.82–0.99) Population mortality stratified by age and calendar year and education level ADT = androgen deprivation therapy; SMR = standardized mortality ratio Table 3 Risk of PCa and other-cause mortality among men on primary ADT compared to observation only. Time period (age) Relative risk of PCa mortality (95% CI) Relative risk of mortality due to causes other than PCa (95% CI) ADT Observation ADT Observation 1985–1994 (70–79y) 1.70 (1.29–2.23) 1.00 (ref) 1.22 (1.00–1.49) 1.00 (ref) 1995–2004 1.55 (1.31–1.84) 1.00 (ref) 1.07 (0.97–1.18) 1.00 (ref) 2005–2014 2.71(2.08–3.53) 1.00 (ref) 1.03 (0.92–1.16) 1.00 (ref) 1985–1994 (>80y) 1.30 (0.89–1.88) 1.00 (ref) 1.09 (0.85–1.39) 1.00 (ref) 1995–2004 1.49 (1.13–1.97) 1.00 (ref) 1.05 (0.92–1.20) 1.00 (ref) 2005–2014 1.65 (1.19–2.29) 1.00 (ref) 1.06 (0.91–1.23) 1.00 (ref) p -value for age–period interaction = 0.237; p for age effect = 0.052; p for period effect = 0.005. Analysis is based on propensity matched pairs PCa = prostate cancer; CI = confidence interval; ADT = androgen deprivation therapy; ref = reference Supplementary Files Supplementarytable1ADT.docx Cite Share Download PDF Status: Published Journal Publication published 12 Mar, 2020 Read the published version in BMC Urology → Version 3 posted Editorial decision: Accept 26 Feb, 2020 Editor assigned by journal 24 Feb, 2020 Submission checks completed at journal 23 Feb, 2020 Editor invited by journal 23 Feb, 2020 You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3869","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":370467,"identity":"e6fe2851-e24f-4088-b559-4b658eff8f7a","order_by":1,"name":"Heikki Seikkula","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABA0lEQVRIie3RMWrDMBiG4V8I5EXgVcHFvcJvDAmBUl3FwkOWBDwGOiSgNZBVpqVnyBWCoFoKXbu1JZCpR8hQ1fHSQabZStE7ScNjf8YAsdgfDIFoskZ/oowCNJALAOavOf8lQSh7Ug4QoGTdHc9EmZ4Eh00SrQvTgEwTVpccb2ft1h0PDeBViEw3e612/uGtZrbmWC/uxXxSGsDwsFel9+8IFdpEW4508Sg4yzicwuTtoyNSnslqlqfu6MnQW0g3jOxoN8xWGVTjYfKs/OejUMayunhAV7RmPs4MDhDnDqPN6Uam26dSfC7vrsWLH9YsUYZIn/h5pd//67LopSAWi8X+dV8GiEnDf52BXgAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0001-9942-1582","institution":"Keski-Suomen keskussairaala","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Heikki","middleName":"","lastName":"Seikkula","suffix":""},{"id":370468,"identity":"fe2f9804-a031-48b6-a69a-61a0c92ba04c","order_by":2,"name":"Peter J. Boström","email":"","orcid":"","institution":"TYKS","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Peter","middleName":"J.","lastName":"Boström","suffix":""},{"id":370469,"identity":"d408269b-de7c-46b5-862b-ea2e4016f8c5","order_by":3,"name":"Karri Seppä","email":"","orcid":"","institution":"Finnish cancer registry","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Karri","middleName":"","lastName":"Seppä","suffix":""},{"id":370470,"identity":"044b9de7-e6c4-47e6-ad34-099d39b788b8","order_by":4,"name":"Janne Pitkäniemi","email":"","orcid":"","institution":"Finnish cancer registry","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Janne","middleName":"","lastName":"Pitkäniemi","suffix":""},{"id":370471,"identity":"8e9bc014-f962-4efe-909c-8645aa0dc8bf","order_by":5,"name":"Nea Malila","email":"","orcid":"","institution":"Finnish cancer registry","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Nea","middleName":"","lastName":"Malila","suffix":""},{"id":370472,"identity":"67931e53-5aa1-41f5-bc06-5717ac0107d3","order_by":6,"name":"Antti Kaipia","email":"","orcid":"","institution":"Tampereen yliopistollinen sairaala","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Antti","middleName":"","lastName":"Kaipia","suffix":""}],"badges":[],"createdAt":"2019-08-15 13:35:42","currentVersionCode":3,"declarations":"","doi":"10.21203/rs.2.13155/v3","doiUrl":"https://doi.org/10.21203/rs.2.13155/v3","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12894-020-00593-7","type":"published","date":"2020-03-12T20:38:03+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":545193,"identity":"d1311869-5fd2-4156-8827-e7534c004854","added_by":"auto","created_at":"2020-02-25 18:34:33","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":665178,"visible":true,"origin":"","legend":"Overall survival among men aged 70–79 years and among men aged 80 or older","description":"","filename":"surv7080overallsurvivalwithoutpropensity.png","url":"https://assets-eu.researchsquare.com/files/b25a646b-2702-4171-bc2f-cad57be39bb5/v3/surv_70_80_overall_survival_without_propensity.png"},{"id":13490557,"identity":"57dd3f12-92cf-450d-a397-5257ec3dfcb4","added_by":"auto","created_at":"2021-09-16 22:24:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":472183,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3869/v3/b3fae67b-75dd-4455-aaf7-df07a1d843de.pdf"},{"id":545192,"identity":"ec0900e8-3c96-40ff-913f-996d7dc35a71","added_by":"auto","created_at":"2020-02-25 18:34:32","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":16157,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementarytable1ADT.docx","url":"https://assets-eu.researchsquare.com/files/b25a646b-2702-4171-bc2f-cad57be39bb5/v3/Supplementarytable1 ADT.docx"}],"financialInterests":"","formattedTitle":"\u003cp\u003eSurvival and mortality of elderly men with localized prostate cancer managed with primary androgen deprivation therapy or by primary observation \u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eAndrogen deprivation therapy (ADT) has been the cornerstone of treatment for locally advanced and metastatic (M+) prostate cancer (PCa) since the 1940s [1]. Immediate ADT or ADT combined with docetaxel or abiraterone acetate is the current treatment of choice for M+ PCa [2]. However, the use of ADT increased sharply between 1989 and 2001 in the USA despite the fact that \u0026le;5% of patients with newly diagnosed PCa have distant metastases at first presentation compared with 20\u0026ndash;25% \u0026ge;20 years ago [3, 4]. While the increased use of ADT is partly accounted for by the uptake of neoadjuvant and adjuvant treatment along with radiation therapy, it is primarily elucidated by ADT for localized disease, especially for elderly patients [5]. Thus, ADT is commonly used to treat localized PCa although it has not been shown to improve survival [6].\u003c/p\u003e\n\u003cp\u003eThe risk of metastases or death from conservatively managed clinical stage T1/T2 cancers was estimated in a meta-analysis of six studies from the era prior to prostate-specific antigen (PSA) [7]. The risk of metastasis at 10 years was found to be 19%, 42%, and 74% for well-differentiated, moderately differentiated, and poorly differentiated tumors, respectively [7]. Similarly, the long-term clinical outcomes of localized PCa without initial treatment with curative intent during the PSA era were assessed [8]. Thirty per cent of the patients died of PCa and 30% of other causes within a 12-year period [8]. A landmark Swedish study demonstrated a benign course of well- or intermediately differentiated PCa in the absence of initial treatment with curative intent [9]. Thus, the clinical course of localized high-risk PCa can be progressive, but the majority of cancers are indolent and slow to progress [2]. According to current guidelines, observation with the option of later treatment in the case of disease progression (i.e., watchful waiting) is recommended for localized and locally advanced PCa in elderly patients with competing comorbidities.\u003c/p\u003e\n\u003cp\u003eThe objective of this observational study was to investigate mortality in elderly PCa patients primarily managed with ADT or observation only during long follow-ups in Finland.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Finnish Cancer Registry is a nationwide population-based register of all incident cancer cases diagnosed in Finland since 1953. The health care personnel in hospitals, outpatient clinics, and healthcare facilities are obligated to notify of new cases. Additionally, pathology notifications are received from all histopathological laboratories in Finland. The registry coverage is estimated at 99% for male genital cancers [10]. The spreading into localized, locally advanced, or metastatic are classified by tumor size, regional node involvement, and presence of metastasis for cases covered by the Finnish Cancer Registry.\u003c/p\u003e\n\u003cp\u003eThe Finnish Cancer Registry data can be linked with the population register center database for dates of death or emigration and causes of death and education levels from Statistics Finland.\u003c/p\u003e\n\u003cp\u003eWe identified all PCa patients aged 70 years or older at diagnosis with localized cancer (clinical stage T1/T2) from 1985 to 2014 and managed by primary ADT or observation in the absence of radical treatment with curative intent (Table 1). Of the total patients identified (\u003cem\u003en\u003c/em\u003e = 16534), 11572 were aged 70\u0026ndash;79 years and 4962 were \u0026ge;80. Within four months of diagnosis, the primary treatment was ADT (ADT group \u003cem\u003en\u003c/em\u003e = 9704), while 6830 received no treatment (observation group) (Table 1). The regional data included 22 hospital districts taking care of specialized care. The survival rates of the patients were compared by age and treatment group over three periods (1985\u0026ndash;1994, 1995\u0026ndash;2004, and 2005\u0026ndash;2014).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOverall survival was evaluated using the life table method [11]. The Poisson regression model was used to quantify differences in patient mortality between the defined groups. The results were reported as relative risk (RR) of PCa-specific mortality (PCSM) and mortality due to causes other than PCa. We also estimated the standardized mortality ratio (SMR) for overall mortality among the patients. The SMR is estimated as the ratio of observed and expected numbers of deaths. The latter was derived from the mortality rates of the male population in Finland stratified by age (1-year intervals) and calendar year. We used a nearest neighbor matching with a logistic regression\u0026ndash;based propensity score [12] to identify a cohort of 5715 paired patients. In the logistic regression, the probability of a given treatment was modeled as a function of age and calendar period (in 5-year groups), education, and hospital district. Interactions between calendar period and each of the covariates were also included in the model. Statistical analysis was performed with R (version 3.2.3) using the packages popEpi [13] and MatchIt [14].\u003c/p\u003e\n\u003cp\u003eThe study protocol was approved by the institutional review board of the Hospital District\u0026nbsp;of\u0026nbsp;Southwest Finland. The National Institute\u0026nbsp;for\u0026nbsp;Health and Welfare (Finland) approved access to the registry data (study number 182/5.05.00/2015). Statistics Finland approved access to the data on the cause of death (study number TK-53-86-17).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe stage distribution of all prostate cancer patients from 1985 to 2014 (\u003cem\u003en\u003c/em\u003e = 95959) in Finland is shown in Supplementary Table 1. Approximately half of the patients were classified as having localized PCa. The proportion of metastatic disease decreased from 28% to 17% between the periods 1985\u0026ndash;1994 and 2005\u0026ndash;2014. However, the PCa stage was missing in nearly one-third of the patients over the study period (Supplementary Table 1). In this study, we included only PCa patients aged 70 years or older at diagnosis who received primary treatment with ADT or no treatment within four months of diagnosis (Table 1).\u003c/p\u003e\n\u003cp\u003eSMR analysis showed that overall mortality was lower in the observation group than in the ADT group in all three time periods. However, a declining trend in SMR over time was seen in both groups. Furthermore, over the most recent period (2005\u0026ndash;2014), patients in both age cohorts had lower overall mortality than the general male population in Finland (SMR: 0.93, 95% CI: 0.88\u0026ndash;0.98) (Table 2). Propensity score matching did not change any of these results.\u003c/p\u003e\n\u003cp\u003eIn both age cohorts, we observed higher PCSM in patients undergoing primary ADT compared to those managed by observation only (Table 3). The relative risk of prostate cancer mortality increased significantly over time in the ADT group compared to the observation group (\u003cem\u003ep\u003c/em\u003e for trend = 0.05). On the other hand, the risk of death from causes other than PCa decreased over time in patients aged 70\u0026ndash;79 years undergoing primary ADT compared to those managed by observation only, but the same was not true in patients aged 80 years or older (Table 3).\u003c/p\u003e\n\u003cp\u003eOverall survival of PCa patients aged 70\u0026ndash;79 years was higher in the observation group than in the ADT group throughout the study period. However, a rising trend was observed in both treatment groups. Among patients over 80 years of age, overall survival improved over time in both treatment groups with no significant differences between them until the most recent period (from 2005 to 2014), when overall survival in the observation group was higher than in the ADT group (Fig. 1). The results remained similar after propensity score matching.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this population-based study, we investigated whether the survival and mortality outcomes in elderly male patients (aged \u0026ge;70 years) with localized PCa is different between those managed by primary observation and those undergoing primary ADT over a long period of time. We showed that the overall SMR of patients in the observation cohort was lower than those in the ADT cohort in both age groups over the entire study period. PCSM and mortality due to causes other than PCa were lower in patients monitored with primary observation compared to those managed with primary ADT. This difference was particularly evident in patients aged 70\u0026ndash;79 years at the time of diagnosis. Overall survival was also higher in subjects in this age group managed by primary observation. By contrast, a smaller difference in PSCM was observed between patients undergoing ADT and those managed by primary observation, while a clear difference in mortality due to other causes was not seen in patients aged 80 or older. This implies a better general health condition and a healthier lifestyle among patients in the observation cohort.\u003c/p\u003e\n\u003cp\u003eAn increased risk of PCSM was observed in patients undergoing primary ADT compared to those managed by primary observation, while a lower risk of other-cause mortality was seen in the younger patient group managed by primary observation. This suggests that in recent times, primary ADT without curative treatment was generally selected for patients with aggressive disease. A 10-year threefold risk of PCSM was associated with poorly differentiated PCa among patients with conservatively managed localized PCa in the Surveillance, Epidemiology, and End Results\u0026nbsp;(SEER) Program [15]. Most male patients with conservatively managed localized PCa aged \u0026gt;66 years with competing comorbidities died from causes other than PCa in a period of 10 years, irrespective of age and tumor aggressiveness [16]. The use of primary ADT was beneficial for patients with aggressive disease and few comorbidities [16]. However, overall mortality was lower in subjects managed by observation than with ADT. We assumed that a shift from ADT to a more radical treatment may have occurred in patients with a good general health status. Since an increasing number of PCa cases has been diagnosed in recent years, and observation is widely utilized in Finland, it is likely that observation was selected for patients with less aggressive histology and without advanced disease. Consequently, fewer male patients died of cancer owing to the slow, natural course of disease.\u003c/p\u003e\n\u003cp\u003eOverall survival was reduced in patients aged 70\u0026ndash;79 years initially treated with. It is still difficult to draw a conclusion from this finding owing to the absence of data on patient comorbidities. However, increased morbidity and mortality from ADT-related side effects is possible. Thus, the survival benefits of ADT are partly offset by its high toxicity. These findings can also be explained by a better general health condition among patients in the observation group. In our cohort, patients in the observation group had a clearly lower risk of overall mortality compared to patients undergoing primary ADT. Since in epidemiological studies the only endpoint that is free from bias is mortality, we can assume that patients in observation cohort were healthier than those in the ADT cohort.\u003c/p\u003e\n\u003cp\u003eMany population-based analyses suggest that gonadotropin-releasing hormone (GnRH) agonist use is associated with a greater risk of coronary artery disease, myocardial infarction, and diabetes mellitus (DM) [17\u0026ndash;19]. Subsequent reports have suggested that male patients with comorbidities or prior cardiovascular disease treated with GnRH agonists might be at increased risk of cardiovascular mortality [20, 21]. Based on these observations, a science advisory consensus statement on GnRH agonist therapy and cardiovascular risk was issued, together with a U.S. Food and Drug Administration safety warning to address concerns of increased risk of myocardial infarction, stroke, sudden cardiac death, and DM [22]. However, conflicting results have been reported. In a recent meta-analysis, ADT use was not associated with an increased risk of cardiovascular death, but with a lower risk of PCSM and all-cause mortality [23]. Studer et al. also reported that ADT for localized PCa may even reduce cardiovascular mortality if started immediately after diagnosis [24].\u003c/p\u003e\n\u003cp\u003eThe current study findings did not support the life-prolonging effects of primary ADT for localized PCa. Several reports have shown similar results: In a prior population-based cohort study on 66717 Medicare patients diagnosed between 1992 and 2009, and who received no definitive local therapy within 180 days of prostate cancer diagnosis, primary ADT was not associated with improved overall long-term CSS or the CSS of patients with localized PCa [25]. Instead, there is evidence that primary ADT led to inferior outcomes [24]. Low overall survival rates were reported for male patients with localized disease treated with primary ADT rather than observation in a previous population-based study [26]. In addition, Potosky et al. reported that primary ADT was neither associated with an enhanced risk of all-cause mortality (hazard ratio [HR] of 1.04, 95% CI: 0.97\u0026ndash;1.11) nor PCa-specific mortality (HR of 1.03; 95% CI: 0.89\u0026ndash;1.19) after adjusting for the sociodemographic and clinical characteristics of patients with localized PCa. However, primary ADT was associated with a decreased risk of all-cause mortality, but not PCSM, among patients at high risk of PCa progression [27].\u003c/p\u003e\n\u003cp\u003ePSA screening practices have increased exponentially over a 30-year period, and regular PSA testing is used frequently among all socioeconomic groups in Scandinavia and Finland [28, 29]. In the early years of the present study, a diagnosis of localized PCa was generally performed via a digital rectal examination or using pathological specimens obtained following a transurethral resection of the prostate. In recent years, most localized PCa cases have been diagnosed by prostate biopsies prompted by elevated PSA values. Moreover, although a proven benefit of the PSA screening of older males has not been shown, PSA testing is frequently performed for elderly patients [30]. The wide-stage migration of PCa from advanced to indolent disease has been reported over \u0026ge;20 years [31]. Thus, a commonly employed but poorly organized screening policy explains the increased rate of PCa in past decades in Finland. Consequently, the number of elderly male patients with PCa has also increased. This implies that the more favorable outcomes associated with the use of primary observation compared to ADT in patients with PCa, especially those in their 70s, can be attributed to PSA-related \u0026ldquo;lead time\u0026rdquo; rather than life extension.\u003c/p\u003e\n\u003cp\u003eOver the study period, staging of metastatic disease in Finland was performed by bone scan examination according to national guidelines until the mid-2000s, after which low-risk PCa patients typically underwent no imaging. The proportion of de novo metastatic PCa in Finland was nearly one-third from 1985 to 1994. This implies that staging procedures of PCa by bone scans were widely performed even in the earlier years of the study period, suggesting a good quality of the TNM classification data of PCa in the Finnish Cancer Registry database. In the Finnish Cancer Registry reports, the proportion of de novo metastatic PCa has recently been around 17%, higher than in Sweden [32], where the incidence of PCa is high and PSA screening is widely performed. This might also indicate a more aggressive PCa histology in cases that are classified as localized by the TNM system, and thus more commonly treated with immediate ADT than cases with less aggressive histology.\u003c/p\u003e\n\u003cp\u003eA few points are worthy of further consideration. As information on patient comorbidities and detailed PCa characteristics (i.e., Gleason scores and PSA values) was not collected, it was not possible to adjust for differences in morbidity and mortality with a potential link to ADT. Thus, a comparison of study outcomes in terms of PCSM and overall survival between the different groups was not possible. Also, due to the absence of data on patient comorbidities and PCa characteristics, it was not possible to determine who would benefit from primary ADT in localized PCa. However, propensity score matching, particularly when applied to socioeconomic status/education level, may have mitigated some of the comorbidity-related limitations. Detailed information on cancer treatment was also incomplete for both treatment groups. Although men in the observation group did not receive ADT or radical treatment in the four months following diagnosis, it is conceivable that some of them may have received treatment later. This limitation may have had a substantial effect on the study outcomes. Furthermore, although the study population included patients with localized PCa, the reliability of the staging procedures over time is debatable. TNM staging was based on mandatory reports obtained from hospitals and pathological laboratories. In other words, clinical practices in Finland were governed by national and/or European prostate cancer guidelines of the time. Consequently, the risk of metastases was evaluated according to these guidelines.\u003c/p\u003e\n\u003cp\u003eNotwithstanding these limitations, the study had several strengths. It was an observational population-based study estimating trends in cancer survival and mortality over time. While we did not directly compare different types of cancer treatments, population-based cohorts yield important information about PCa treatment in real-life situations, as the populations in randomized controlled trials are selected using stringent criteria by excluding out substantial proportion of real-life patients. However, in population-based studies patients are also allocated to different treatments, and results based on those can be subject to errors when comorbidities are involved. From an epidemiological perspective, these data determine the Finnish results obtained for patients managed with primary ADT or by observation. This study was based on nationwide data for PCa and included nearly 100% of patients in Finland over a nearly 30-year period. No previous population-based results from Finland on this subject have been published. Similar complete population-based coverage is not available in many European countries.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePrimary ADT within four months period from diagnosis is not associated with improved long-term overall survival or decreased PCSM than primary conservative management for men with localized PCa. However, the study\u0026rsquo;s results may have been affected by patient selection or treatment intention general health and healthcare service\u0026ndash;related factors.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate: The study protocol was approved by the institutional review board of the Hospital District\u0026nbsp;of\u0026nbsp;Southwest Finland (Study number: ETMK:116/1802/2014). The National Institute for Health and Welfare (Finland) approved access to the registry data (study number 182/5.05.00/2015). Statistics Finland approved access to the data on the cause of death (study number TK-53-86-17).\u003c/p\u003e\n\u003cp\u003eConsent for publication: Not applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials: The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003eCompeting interests: The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding: None.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo; contributions: AK, PB, NM, and JP designed the study. HS and KS performed the data acquisition. KS, HS, and JP analyzed and interpreted the data regarding prostate cancer and androgen deprivation therapy. HS, AK, and NM wrote the manuscript draft. AK, NM, JP, and PB revised the text for important intellectual content. AK, PB, and NM supervised the work. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003eAcknowledgements: Not applicable.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eADT = androgen deprivation therapy\u003c/p\u003e\n\u003cp\u003ePCa = prostate cancer\u003c/p\u003e\n\u003cp\u003eRR = relative risk\u003c/p\u003e\n\u003cp\u003ePCSM = prostate cancer\u0026ndash;specific mortality\u003c/p\u003e\n\u003cp\u003eSMR = standardized mortality ratio\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHuggins C, Stevens R, Hodges C. Studies on prostatic cancer: II. The effects of castration on advanced carcinoma of the prostate gland. Arch Surg 1941, 43(2):209\u0026ndash;223.\u003c/li\u003e\n\u003cli\u003eEuropean Association of Urology Guidelines. 2018 Edition. ESTRO \u0026ndash; ESUR \u0026ndash;SIOG Prostate Cancer Guidelines Panel. EAU \u0026ndash; ESTRO \u0026ndash; ESUR \u0026ndash; SIOG Guidelines on Prostate Cancer. Available from: [https://uroweb.org/guideline/prostate-cancer/]\u003c/li\u003e\n\u003cli\u003eRyan CJ, Small EJ. Early versus delayed androgen deprivation for prostate cancer: new fuel for an old debate. J Clin Oncol. 2005, 23(32):8225\u0026ndash;1.\u003c/li\u003e\n\u003cli\u003eCooperberg MR, Grossfeld GD, Lubeck DP, Carroll PR. National practice patterns and time trends in androgen ablation for localized prostate cancer. J Natl Cancer Inst 2003, 95(13):981\u0026ndash;89.\u003c/li\u003e\n\u003cli\u003eBasaria S, Bhasin S. Targeting the skeletal muscle\u0026ndash;metabolism axis in prostate-cancer therapy. N Engl J Med. 2012, 367(10):965\u0026ndash;67.\u003c/li\u003e\n\u003cli\u003eLu-Yao GL, Albertsen PC, Moore DF, Shih W, Lin Y, DiPaola RS, et al. Survival following primary androgen deprivation therapy among men with localized prostate cancer. JAMA 2008, 300(2):173\u0026ndash;81.\u003c/li\u003e\n\u003cli\u003eChodak GW, Thisted RA, Gerber GS, Johansson JE, Adolfsson J, Jones GW, et al. Results of conservative management of clinically localized prostate cancer. N Engl J Med 1994, 330(4):242\u0026ndash;48.\u003c/li\u003e\n\u003cli\u003eKattan MW, Cuzick J, Fisher G, Berney DM, Oliver T, Foster CS, et al. Nomogram incorporating PSA level to predict cancer-specific survival for men with clinically localized prostate cancer managed without curative intent. Cancer 2008, 112(1):69-74.\u003c/li\u003e\n\u003cli\u003eJohansson JE, Andren O, Andersson SO, Dickman PW, Holmberg L, Magnuson A, et al. Natural history of early, localized prostate cancer. JAMA 2004, 291(22):2713\u0026ndash;19.\u003c/li\u003e\n\u003cli\u003eLeinonen MK, Miettinen J, Heikkinen S, Pitkaniemi J, Malila N. Quality measures of the population-based Finnish Cancer Registry indicate sound data quality for solid malignant tumours. Eur J Cancer 2017, 77:31\u0026ndash;39.\u003c/li\u003e\n\u003cli\u003eCutler SJ, Ederer F. Maximum utilization of the life table method in analyzing survival. J Chronic Dis. 1958, 8(6):699\u0026ndash;712.\u003c/li\u003e\n\u003cli\u003eHo D, Imai K, King G, Stuart E. Matching as nonparametric processing for reducing model dependence in parametric causal inference. Political Analysis 2007, 15(3):199\u0026ndash;236.\u003c/li\u003e\n\u003cli\u003epopEpi: Functions for epidemiological analysis using population data. R package version 0.2.1 [http://cran.r-project.org/package=popEpi]\u003c/li\u003e\n\u003cli\u003eHo D, Imai K, King G, Stuart E. MatchIt: Nonparametric preprocessing for parametric causal inference. Journal of Statistical Software 2011, 42(8):1\u0026ndash;28.\u003c/li\u003e\n\u003cli\u003eLu-Yao GL, Albertsen PC, Moore DF, Shih W, Lin Y, DiPaola RS, et al. Outcomes of localized prostate cancer following conservative management. JAMA 2009, 302(11):1202\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eAlbertsen PC, Moore DF, Shih W, Lin Y, Li H, Lu-Yao GL. Impact of comorbidity on survival among men with localized prostate cancer. J Clin Oncol. 2011, 29(10):1335\u0026ndash;41.\u003c/li\u003e\n\u003cli\u003eKeating NL, O'Malley AJ, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol. 2006, 24(27):4448\u0026ndash;56.\u003c/li\u003e\n\u003cli\u003eKeating NL, O'Malley AJ, Freedland SJ, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy: observational study of veterans with prostate cancer. J Natl Cancer Inst 2010, 102(1):39\u0026ndash;46.\u003c/li\u003e\n\u003cli\u003eD'Amico AV, Denham JW, Crook J, Chen MH, Goldhaber SZ, Lamb DS, et al. Influence of androgen suppression therapy for prostate cancer on the frequency and timing of fatal myocardial infarctions. J Clin Oncol. 2007, 25(17):2420\u0026ndash;25.\u003c/li\u003e\n\u003cli\u003eSaigal CS, Gore JL, Krupski TL, Hanley J, Schonlau M, Litwin MS. Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer 2007, 110(7):1493\u0026ndash;1500.\u003c/li\u003e\n\u003cli\u003eNanda A, Chen MH, Braccioforte MH, Moran BJ, D'Amico AV. Hormonal therapy use for prostate cancer and mortality in men with coronary artery disease-induced congestive heart failure or myocardial infarction. JAMA 2009, 302(8):866\u0026ndash;73.\u003c/li\u003e\n\u003cli\u003eLevine GN, D'Amico AV, Berger P, Clark PE, Eckel RH, Keating NL, et al. Androgen-deprivation therapy in prostate cancer and cardiovascular risk: a science advisory from the American Heart Association, American Cancer Society, and American Urological Association: endorsed by the American Society for Radiation Oncology. 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JAMA internal medicine 2014, 174(9):1460\u0026ndash;67.\u003c/li\u003e\n\u003cli\u003eWong YN, Freedland SJ, Egleston B, Vapiwala N, Uzzo R, Armstrong K. The role of primary androgen deprivation therapy in localized prostate cancer. Eur Urol 2009, 56(4):609\u0026ndash;16.\u003c/li\u003e\n\u003cli\u003ePotosky AL, Haque R, Cassidy-Bushrow AE, Ulcickas Yood M, Jiang M, Tsai HT, et al. Effectiveness of primary androgen-deprivation therapy for clinically localized prostate cancer. J Clin Oncol. 2014, 32(13):1324\u0026ndash;30.\u003c/li\u003e\n\u003cli\u003eNordstrom T, Bratt O, Ortegren J, Aly M, Adolfsson J, Gronberg H. A population-based study on the association between educational length, prostate-specific antigen testing and use of prostate biopsies. Scand J Urol 2016, 50(2):104\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eKilpelainen TP, Pogodin-Hannolainen D, Kemppainen K, Talala K, Raitanen J, Taari K, et al. Estimate of Opportunistic Prostate Specific Antigen Testing in the Finnish Randomized Study of Screening for Prostate Cancer. J Urol 2017, 198(1):50\u0026ndash;57.\u003c/li\u003e\n\u003cli\u003eVickers AJ, Sjoberg DD, Ulmert D, Vertosick E, Roobol MJ, Thompson I, et al. Empirical estimates of prostate cancer overdiagnosis by age and prostate-specific antigen. BMC medicine 2014, 12:26.\u003c/li\u003e\n\u003cli\u003eStamey TA, Caldwell M, McNeal JE, Nolley R, Hemenez M, Downs J. The prostate specific antigen era in the United States is over for prostate cancer: what happened in the last 20 years? J Urol 2004, 172(4 Pt 1):1297\u0026ndash;1301.\u003c/li\u003e\n\u003cli\u003eWesterberg M, Franck Lissbrant I, Damber JE, Robinson D, Garmo H, Stattin P. Temporal changes in survival in men with de novo metastatic prostate cancer: nationwide population-based study. Acta oncologica (Stockholm, Sweden) 2019:1\u0026ndash;6.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cstrong\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTable 1\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eStudy population of prostate cancer patients\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" style=\"width:529.45pt;margin-left:-40.4pt;border-collapse:collapse;\" width=\"706\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 27.5pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 425.25pt;padding: 0in 3.5pt;height: 27.5pt;vertical-align: bottom;\" valign=\"bottom\" width=\"80.31161473087819%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; All patients\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 184.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"34.844192634560905%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;ADT\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 240.95pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"45.46742209631728%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Observation\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eVariable\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; N\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; %\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;N\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:center;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; %\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eAge at diagnosis\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e70–74\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3096\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e31.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2850\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e41.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e75–79\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3411\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e35.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2215\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 12.3pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e32.4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 14pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e80–84\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 14pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2170\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 14pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e22.4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 14pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1227\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 14pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e18.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.4pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e85–89\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.4pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e832\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.4pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.4pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e438\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.4pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6.4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026gt;90\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e195\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTotal\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9704\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6830\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eYear of diagnosis\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1985–1989\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e785\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8.1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e208\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1990–1994\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1197\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e12.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e337\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1995–1999\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1724\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e17.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e797\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e11.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2000–2004\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2159\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e22.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1313\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e19.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2005–2009\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2280\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e23.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2194\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e32.1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2010–2014\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1559\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e16.1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1981\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e29.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTotal\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9704\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6830\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\n \u003cbr\u003e\n \u003c/span\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eBasic\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6920\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e71.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4421\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e64.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eSecondary\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1325\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e13.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1074\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e15.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eHigh\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1459\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 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style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eUusimaa\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e932\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 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style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePirkanmaa\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1187\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e12.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e614\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePaijat-Hame\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e668\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e304\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e4.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New 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style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e182\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eEtela-Karjala\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e321\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New 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11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e64\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePohjois-Karjala\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New 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style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePohjois-Savo\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n 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style=\"color: rgb(0, 0, 0);\"\u003e403\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eKeski-Suomi\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e374\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e3.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e557\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e8.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New 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style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e386\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eVaasa\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e285\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New 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width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e128\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New 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valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e5.4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eKainuu\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New 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style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eLansi-Pohja\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e280\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e132\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eLappi\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e190\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e177\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eÅland\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e34\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e56\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 11.35pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e0.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 104.2pt;padding: 0in 3.5pt;height: 17.85pt;vertical-align: bottom;\" valign=\"bottom\" width=\"19.688385269121813%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTotal\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85.05pt;padding: 0in 3.5pt;height: 17.85pt;vertical-align: bottom;\" valign=\"bottom\" width=\"16.005665722379604%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e9704\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99.25pt;padding: 0in 3.5pt;height: 17.85pt;vertical-align: bottom;\" valign=\"bottom\" width=\"18.69688385269122%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106.3pt;padding: 0in 3.5pt;height: 17.85pt;vertical-align: bottom;\" valign=\"bottom\" width=\"20.113314447592067%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e6830\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134.65pt;padding: 0in 3.5pt;height: 17.85pt;vertical-align: bottom;\" valign=\"bottom\" width=\"25.495750708215297%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;text-align:right;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e100\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eADT = androgen deprivation therapy; N = number\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-size:16px;line-height:200%;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\n \u003cbr\u003e\u0026nbsp;\n \u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ch1 style=\"margin-top:24.0pt;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:32px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-size: 16px;\"\u003eTable 2\u003c/span\u003e\u0026nbsp;\u003cspan style=\"font-size: 16px; font-weight: normal;\"\u003eOverall mortality of the study patients compared to that of the male population of Finland.\u003c/span\u003e\u003c/span\u003e\u003c/h1\u003e\n\u003cdiv align=\"left\" style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\n \u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"width:481.1pt;border-collapse:collapse;border:none;\" width=\"641\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 375.6pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"78.1591263650546%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;text-align:center;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003ePeriod\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003eAll patients\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 125.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.053042121684868%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1985–1994\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 125.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.053042121684868%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1995–2004\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 125.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"26.053042121684868%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e2005–2014\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eADT\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eObservation\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eADT\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eObservation\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eADT\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eObservation\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;text-align:center;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eAge\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"6\" style=\"width: 375.6pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"78.1591263650546%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;text-align:center;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eSMR (95% confidence interval)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;text-align:center;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eAll (\u0026gt;70)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.48 (1.41–1.54)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.20 (1.10–1.30)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.19 (1.15–1.23)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.03 (0.98–1.08)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.08 (1.03–1.13)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e0.93 (0.88–0.98)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e70–79\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.57 (1.48–1.65)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.17 (1.05–1.30)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.24 (1.19–1.29)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.05 (0.99–1.11)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.11 (1.04– 1.19)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e0.95 (0.88–1.01)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;text-align:center;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e≥\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e80\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.39 (1.22– 1.42)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.25 (1.08–1.43)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.10 (1.04–1.17)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.00 (0.92–1.09)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.04 (0.97–1.11)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e0.89 (0.82–0.97)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003eMatched pairs\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;text-align:center;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eAll (\u0026gt;70)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.50\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.38–1.63)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.19\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.09–1.30)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.19\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.13–1.25)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.03\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(0.98–1.08)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.09\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.03–1.15)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e0.93\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(0.87–0.98)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e70–79\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.57\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.41–1.74)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.16\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.04–1.29)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.23\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.16– 1.30)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.05\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(0.99–1.11)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.12\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.05–1.20)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: 1pt solid rgb(127, 127, 127);border-left: none;border-bottom: 1pt solid rgb(127, 127, 127);border-right: none;padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e0.94\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(0.87–1.01)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 63.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"13.104524180967239%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u003cspan style=\"font-family: \u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.3pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"8.736349453978159%\"\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;text-align:center;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e≥\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e80\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.39\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.21– 1.60)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.25\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.08–1.44)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.12\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(1.02–1.21)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.00\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(0.91–1.08)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 47pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"9.82839313572543%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e1.03\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(0.94– 1.12)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78.2pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid rgb(127, 127, 127);padding: 0in 5.4pt;height: 49.95pt;vertical-align: top;\" valign=\"top\" width=\"16.224648985959437%\"\u003e\n \u003cp style=\"margin-top:1.8pt;margin-right:0in;margin-bottom:1.8pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e0.91\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e(0.82–0.99)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePopulation mortality stratified by age and calendar year and education level\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003eADT = androgen deprivation therapy; SMR = standardized mortality ratio\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin-top:0in;margin-right:0in;margin-bottom:6.0pt;margin-left:0in;font-size:16px;font-family:\u0026quot;Calibri\u0026quot;,sans-serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cspan style=\"font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003eRisk of PCa and other-cause mortality among men on primary ADT compared to observation only.\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border-collapse:collapse;border:none;\" width=\"641\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109.35pt;border: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.741433021806852%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eTime period (age)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 179.05pt;border-top: 1pt solid black;border-right: 1pt solid black;border-bottom: 1pt solid black;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"37.22741433021807%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eRelative risk of PCa mortality\u003c/span\u003e\u003c/p\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e(95% CI) \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 192.7pt;border-top: 1pt solid black;border-right: 1pt solid black;border-bottom: 1pt solid black;border-image: initial;border-left: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"40.03115264797508%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eRelative risk of mortality due to causes other than PCa (95% CI)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109.35pt;border-right: 1pt solid black;border-bottom: 1pt solid black;border-left: 1pt solid black;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.741433021806852%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82.15pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"17.133956386292834%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eADT\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.9pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eObservation\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95.75pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"19.937694704049843%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eADT\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.95pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003eObservation\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109.35pt;border-right: 1pt solid black;border-bottom: 1pt solid black;border-left: 1pt solid black;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.741433021806852%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1985–1994 \u003cstrong\u003e(70–79y)\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82.15pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"17.133956386292834%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.70 (1.29–2.23)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.9pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95.75pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"19.937694704049843%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.22 (1.00–1.49)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.95pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109.35pt;border-right: 1pt solid black;border-bottom: 1pt solid black;border-left: 1pt solid black;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.741433021806852%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1995–2004\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82.15pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"17.133956386292834%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.55 (1.31–1.84)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.9pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95.75pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"19.937694704049843%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.07 (0.97–1.18)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.95pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109.35pt;border-right: 1pt solid black;border-bottom: 1pt solid black;border-left: 1pt solid black;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.741433021806852%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2005–2014\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82.15pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"17.133956386292834%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2.71(2.08–3.53)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.9pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95.75pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"19.937694704049843%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.03 (0.92–1.16)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.95pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109.35pt;border-right: 1pt solid black;border-bottom: 1pt solid black;border-left: 1pt solid black;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.741433021806852%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1985–1994 \u003cstrong\u003e(\u0026gt;80y)\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82.15pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"17.133956386292834%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.30 (0.89–1.88)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.9pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95.75pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"19.937694704049843%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.09 (0.85–1.39)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.95pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109.35pt;border-right: 1pt solid black;border-bottom: 1pt solid black;border-left: 1pt solid black;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.741433021806852%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1995–2004\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82.15pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"17.133956386292834%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.49 (1.13–1.97)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.9pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95.75pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"19.937694704049843%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.05 (0.92–1.20)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.95pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109.35pt;border-right: 1pt solid black;border-bottom: 1pt solid black;border-left: 1pt solid black;border-image: initial;border-top: none;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"22.741433021806852%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e2005–2014\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 82.15pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"17.133956386292834%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.65 (1.19–2.29)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.9pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95.75pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"19.937694704049843%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.06 (0.91–1.23)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96.95pt;border-top: none;border-left: none;border-bottom: 1pt solid black;border-right: 1pt solid black;padding: 0in 5.4pt;vertical-align: top;\" valign=\"top\" width=\"20.093457943925234%\"\u003e\n \u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e1.00 (ref)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003e\u003cem\u003ep\u003c/em\u003e-value for age–period interaction = 0.237; \u003cem\u003ep\u003c/em\u003e for age effect = 0.052; \u003cem\u003ep\u003c/em\u003e for period effect = 0.005. Analysis is based on propensity matched pairs\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"margin:0in;margin-bottom:.0001pt;font-size:16px;font-family:\u0026quot;Times New Roman\u0026quot;,serif;line-height:200%;\"\u003e\u003cspan style=\"color: rgb(0, 0, 0);\"\u003ePCa = prostate cancer; CI = confidence interval; ADT = androgen deprivation therapy; ref = reference\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"buro","sideBox":"Learn more about [BMC Urology](http://bmcurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/buro/default.aspx","title":"BMC Urology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Prostate cancer survival, Prostate cancer–specific mortality, Localized prostate cancer, Androgen deprivation therapy","lastPublishedDoi":"10.21203/rs.2.13155/v3","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.13155/v3","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Androgen deprivation therapy (ADT) remains a primary treatment for localized prostate cancer (PCa) even though there is no evidence that its use is beneficial in the absence of curative treatment.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Men aged ≥70 years (\u003cem\u003en\u003c/em\u003e = 16534) diagnosed with localized PCa from 1985 to 2014 and managed either with primary observation or ADT in the absence of curative treatment were included. The cases were identified from the population-based Finnish Cancer Registry. We estimated the standardized mortality ratios (SMR) for overall mortality by treatment group. We determined the relative risk (RR) of PCa-specific mortality (PCSM) and other-cause mortality between the two treatment groups. Survival was determined using the life table method. Two age groups (70–79 years and ≥80 years) and three calendar time cohorts (1985–1994, 1995–2004, and 2005–2014) were compared following adjustment of propensity score matching between the treatment groups with four covariates (age, year of diagnosis, educational level, and hospital district). Follow-up continued until death or until December 31, 2015. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Patients in the observation group had lower overall SMRs than those in the ADT group in both age cohorts over the entire study period. PCSM was higher in men aged 70–79 years undergoing primary ADT compared to those managed by observation only (RR: 1.70, 95% confidence interval [CI]: 1.29–2.23 [1985–1994]; RR 1.55, 95% CI: 1.35–1.84 [1995–2004]; and RR 2.71, 95% CI: 2.08–3.53 [2005–2014]); \u003cem\u003ep\u003c/em\u003e = 0.005 for periodic trend. A similar trend over time was also observed in men aged \u0026gt;80 years; (\u003cem\u003ep\u003c/em\u003e for age–period interaction = 0.237). Overall survival was also higher among men in their 70’s managed by observation compared to those undergoing ADT.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e Primary ADT within four months period from diagnosis is not associated with improved long-term overall survival or decreased PCSM compared to primary conservative management for men with localized PCa. However, this observational study’s conclusions should be weighted with confounding factors related to cancer aggressiveness and comorbidities.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"Survival and mortality of elderly men with localized prostate cancer managed with primary androgen deprivation therapy or by primary observation","msid":"","msnumber":"","nonDraftVersions":[{"code":3,"date":"2020-02-25 18:34:32","doi":"10.21203/rs.2.13155/v3","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Accept","date":"2020-02-26T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2020-02-24T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-02-23T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-02-23T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"buro","sideBox":"Learn more about [BMC Urology](http://bmcurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/buro/default.aspx","title":"BMC Urology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":2,"date":"2019-12-31 20:38:07","doi":"10.21203/rs.2.13155/v2","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Minor revision","date":"2020-02-18T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-01-22T12:00:00+00:00","index":3,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n* Please confirm that you have included your review in the ‘Comments to Author’ box?: ** Yes**\n* Are the methods appropriate and well described to allow independent reproduction of experiments?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are you able to assess the statistics?: ** I have been able to assess all of the statistics in this manuscript (please refer to checklist above)**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Quality of written English: **Acceptable**\n* Should the manuscript be highlighted for promotional activity?: **No**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n\nComments to Author:\n---\nMajor comment\nI understand the situation in this study for detail risk assessment is not applicable. And I agree with the description added in the conclusion. However the description in this revised version of the manuscript remains that readers might understand \"primary ADT group\" as \"treated ADT only, no change to more aggressive treatment\". On the other hands, \"primary conservative management group\" might be recognized \"no additional treatment such as ADT entire of the treatment period up to death\". I suggest that authors describe this comparison between \"ADT group\" and \"observation group\" are defined within four months of diagnosis, that means the comparison of \"Initial treatment policy\" clearly in the conclusion."},{"type":"editorInvitedReview","content":"","date":"2020-01-10T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n* Please confirm that you have included your review in the ‘Comments to Author’ box?: ** Yes**\n* Are the methods appropriate and well described to allow independent reproduction of experiments?: **Yes**\n* Does the work include the necessary controls?: **N/A**\n* Are you able to assess the statistics?: ** I have been able to assess all of the statistics in this manuscript (please refer to checklist above)**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Quality of written English: **Acceptable**\n* Should the manuscript be highlighted for promotional activity?: **No**\n* Declaration of competing interests: **'I declare that I have no competing interests'**\n\nComments to Author:\n---\nFollowing revision the paper is acceptable for publication, is has improved as a consequence of the review process"},{"type":"editorInvitedReview","content":"","date":"2020-01-10T12:00:00+00:00","index":2,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n* Please confirm that you have included your review in the ‘Comments to Author’ box?: ** Yes**\n* Are the methods appropriate and well described to allow independent reproduction of experiments?: **Yes**\n* Does the work include the necessary controls?: **N/A**\n* Are you able to assess the statistics?: ** I have been able to assess all of the statistics in this manuscript (please refer to checklist above)**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Quality of written English: **Acceptable**\n* Should the manuscript be highlighted for promotional activity?: **No**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n\nComments to Author:\n---\nIn this revised manuscript, the authors investigated mortality in elderly PCa patients primarily treated with ADT or observation only during a long follow-up in Finland. They concluded that conservative management was a valid option for patients with localized PCa in whom curative treatment was not possible. Although in such an observation study it was difficult to adjust risk factors between ADT and observation groups and thus there is a limitation in translation of the findings, all the points raised by the reviewers have been appropriately responded in the revised version. Therefore, the revised version of the manuscript became more reasonable for reading and understanding."},{"type":"reviewerAgreed","content":"","date":"2020-01-09T12:00:00+00:00","index":3,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2020-01-07T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-01-07T12:00:00+00:00","index":1,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-01-07T12:00:00+00:00","index":2,"fulltext":""},{"type":"editorAssigned","content":"","date":"2019-12-26T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-12-25T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-12-25T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"buro","sideBox":"Learn more about [BMC Urology](http://bmcurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/buro/default.aspx","title":"BMC Urology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2019-08-20 23:26:13","doi":"10.21203/rs.2.13155/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2019-11-27T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2019-11-22T12:00:00+00:00","index":2,"fulltext":"Recommendation: Reject\nForm responses:\n---\n* Please confirm that you have included your review in the ‘Comments to Author’ box?: ** Yes**\n* Are the methods appropriate and well described to allow independent reproduction of experiments?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are you able to assess the statistics?: ** I have been able to assess all of the statistics in this manuscript (please refer to checklist above)**\n* Are the conclusions drawn adequately supported by the data shown?: **No**\n* Quality of written English: **Not suitable for publication unless extensively edited**\n* Should the manuscript be highlighted for promotional activity?: **No**\n* Declaration of competing interests: **I declare that I have no competing interests**\n\nComments to Author:\n---\nReview comments to\n\nA comparison of survival and mortality outcomes for older men with localized prostate cancer treated with either primary androgen deprivation therapy or primary observation\n\nA nicely conducted population-based study including a large sample of patients registered with localized prostate cancer and followed for survival endpoints for a sufficient amount of time. The object of the study to evaluate the mortality of patients with localized prostate cancer managed with either endocrine treatment or observation.\nPatients were included if they had clinical localized prostate cancer reported. It is unclear how this was determined. In the methods section it is stated, that all TNM classification was retrieved, however this information is not presented, and likely given the fact that the majority of men included were elderly when diagnosed the work-up has been limited, that is a large number of Nx / Mx should be expected.\nOut-come following conservative management of localized prostate cancer depends on a number of prognostic factors some of which relates to the disease while others relates to comorbidities. Information on important prognostic factors as PSA at diagnosis, clinical stage, and histopathological grading is missing, which invalidates the conclusions.\nInformation on treatment beyond the first 4 months is not reported, thus concluding that conservative treatment - in the sense no treatment is a valid option - may not be true. In fact, it is likely that a number of patients managed conservatively from the start has subsequently received some kind of therapy when progressing, which influences the results in terms survival in an unpredictable manner.\nReporting that PCa-specific survival in an observation only group compared to an early ADT group makes little sense when the results are unadjusted for clinical relevant prognostic markers as PSA and Gleason score.\n"},{"type":"editorInvitedReview","content":"","date":"2019-11-19T12:00:00+00:00","index":3,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n* Please confirm that you have included your review in the ‘Comments to Author’ box?: ** Yes**\n* Are the methods appropriate and well described to allow independent reproduction of experiments?: **No**\n* Does the work include the necessary controls?: **No**\n* Are you able to assess the statistics?: ** I have been able to assess all of the statistics in this manuscript (please refer to checklist above)**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Quality of written English: **Acceptable**\n* Should the manuscript be highlighted for promotional activity?: **No**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n\nComments to Author:\n---\nMajor comments\n\n1. Risk of patients categorized into Observation group\nAuthors identified treatment group as \"no treatment within four months of diagnosis\". However, authors did not consider risk of prostate cancer such as PSA value at diagnosis and percent positive biopsy core. According to the EAU guideline, active surveillance and watchful waiting are strongly recommended to low-risk patients. Therefore, many low-risk patients classified into observation group in this study, Low-risk disease patients are better prognosis than other risk groups. Authors should avoid the bias of the risk between observation group and ADT group. No matter what statistical technique may use, it cannot be a correct result.\n\n2. Definition of ATD group\nAuthors defined ADT group as \"ADT within four months of the diagnosis\". According to the EAU guideline, combination of radiation therapy with ADT has definitively proven its superiority compared with radiation alone. For high-risk patients, long term ADT is recommended prior to the radiation therapy. In this study, ADT group contains the high-risk patient treated by radiation therapy with prior long term ADT, and ADT group was considered poor prognosis than observation group. Authors should describe the percentage of the patients in the ADT group who are treated by radiation therapy.\n\n3. Survival analysis in this study\nThe risk difference between the observation and ADT group is potentially exist described above. The mortality risk of ADT group expected higher than observation group in which many low-risk disease is contained. After the adjustment of risk considered using valued of PSA value at diagnosis, PSA velocity and % positive core, it will be an appropriate comparison of survival data between two groups. The results of prognosis should be matched by risk of prostate cancer. Authors should perform proper methods for risk adjustment for the analysis dataset. I do not think that it is a comparable data without risk adjustment of the disease.\n"},{"type":"reviewerAgreed","content":"","date":"2019-11-11T12:00:00+00:00","index":3,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2019-11-11T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept after minor essential revisions\nForm responses:\n---\n* Please confirm that you have included your review in the ‘Comments to Author’ box?: ** Yes**\n* Are the methods appropriate and well described to allow independent reproduction of experiments?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are you able to assess the statistics?: ** I have been able to assess all of the statistics in this manuscript (please refer to checklist above)**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Quality of written English: **Needs some language corrections before being published**\n* Should the manuscript be highlighted for promotional activity?: **No**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n\nComments to Author:\n---\nIn this manuscript, the authors investigated mortality in elderly PCa patients primarily treated with ADT or observation only during a long follow-up in Finland. They concluded that conservative management was a valid option for patients with localized PCa in whom curative treatment was not possible. Although the theme of the present study is important and this large population-based study using nationwide data over 30-year period is valuable, there are several points to be dissolved.\n\nMajor points\n1. It must be agreed that ADT would have anticancer effects on almost all patients with PCa, including PSA decline, tumor shrinkage and improvement of symptoms. On the contrary, the present study manifested negative effects of ADT on PCSM, compared to observation only. Thus, to accept inferior PCSM in ADT group, it is required to prove harmful effects of ADT on PCa other than side effects. The authors are encouraged to describe any explanation or speculation regarding harm of ADT on PCa.\n\nMinor points\n1. Description of references is not consistent, especially for abbreviation of names of journals.\n"},{"type":"reviewerAgreed","content":"","date":"2019-11-10T12:00:00+00:00","index":2,"fulltext":""},{"type":"reviewerAgreed","content":"","date":"2019-11-09T12:00:00+00:00","index":1,"fulltext":""},{"type":"checksComplete","content":"","date":"2019-08-14T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-08-14T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewersInvited","content":"","date":"2019-08-14T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-08-13T12:00:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"","date":"2019-08-09T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-urology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"buro","sideBox":"Learn more about [BMC Urology](http://bmcurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/buro/default.aspx","title":"BMC Urology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bc65e40b-e7ad-48cc-9e94-55b6ff9376e6","owner":[],"postedDate":"February 25th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":46013,"name":"Oncology"}],"tags":[],"updatedAt":"2021-08-05T22:33:45+00:00","versionOfRecord":{"articleIdentity":"rs-3869","link":"https://doi.org/10.1186/s12894-020-00593-7","journal":{"identity":"bmc-urology","isVorOnly":false,"title":"BMC Urology"},"publishedOn":"2020-03-12 20:38:03","publishedOnDateReadable":"March 12th, 2020"},"versionCreatedAt":"2020-02-25 18:34:32","video":"","vorDoi":"10.1186/s12894-020-00593-7","vorDoiUrl":"https://doi.org/10.1186/s12894-020-00593-7","workflowStages":[]},"version":"v3","identity":"rs-3869","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-3869","version":["v3"]},"buildId":"i_I_jhV-QviBjPLXJga9V","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}