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Read the full open access research: http://www.bmj.com/content/348/bmj.g1502 Prostate cancer is the commonest non-dermatological cancer and the second leading cause of cancer related death in men in the Western world. In more than 90% of cases the cancer is localised, and radical prostatectomy, radiotherapy, and active surveillance represent the main treatment options. In this nationwide population based cohort study the researchers assessed prostate cancer related mortality in patients in the Swedish national prostate cancer registry, who underwent radical prostatectomy or radiotherapy as their primary treatment. Linkage with other healthcare and demographic databases enabled reduction of potential confounding through statistical techniques as well as adjustment for competing risks of mortality, as many men with prostate cancer are known to die of other causes. The authors hypothesised that survival differences would vary by treatment, and that age and the burden from comorbidities would have an impact on survival.