We wish to thank Harding and colleagues for taking their time reading and commenting on our analysis of cancer incidence in advanced age (1), and would want to take this opportunity to rectify some misinterpretations.

Harding and colleagues claim that prevalent autopsy findings overestimate the true cancer occurrence in advanced age and that the overestimation increases gradually with age due to the accumulation of indolent, i.e., nonclinically significant, tumors in the elderly. Harding and colleagues also quote us stating “that Sweden's medical system fails to diagnose or treat most cancers in the very old”. We argue that the age-incidence pattern is indeed driven by underreporting and underdiagnosing of cancer but refrain from interpreting this as being a “system failure”. Underreporting in the elderly is certainly an issue since the proportion of pathology-confirmed cancers declines over age (Fig. 1; ref. 1), and the completeness of the Swedish Cancer...

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