"In the wake of a widely publicized report advising against prostatespecific antigen PSA testing for prostate cancer a new study finds not screening would triple the number of U.S. men developing advanced cancer.    Testing on the other hand might keep some  men each year from receiving a diagnosis of latestage prostate cancer  cancer that has spread and is far less curable  the study finds.    PSA testing for all its pluses and minuses and all that . . . permits you to catch the disease earlier said lead researcher Dr. Edward Messing chair of urology at the University of Rochester Medical Center in Rochester N.Y.    These people are all going to die they are going to die incredibly expensively and die miserably he said referring to the many men whose diagnoses would be delayed by not testing. I dont know that all these people could be saved with PSA testing but many could he added.    The report was published online July  in the journal Cancer.    Messing said the annual number of prostate cancer deaths dropped from about  in the s to  now. The only thing that can explain that is PSA early detection and treatment he said.    Many cases of prostate cancer are not lifethreatening which is why testing is controversial. The U.S. Preventive Services Task Force USPSTF in May recommended against routine PSA screening saying too many nonlethal cancers were being treated aggressively exposing men who didnt need treatment to serious side effects such as impotence and urinary incontinence.    But Messing disagreed with that advice. Condemning PSA testing wasnt a brilliant conclusion he said.    For the new study Messings team compared information from the U.S. Surveillance Epidemiology and End Results database for the years  to   immediately before widespread PSA testing started  to data from  through .    In the  data  cases of prostate cancer were diagnosed after the malignancy had spread to other parts of the body.    Using these cases as a base the researchers constructed a model that used data of advanced cancer diagnosed in the s and predicted how many cases of advanced cancer would have been diagnosed in  if PSA testing was not done.    Their model showed instead of  actual cases in  about  cases would have been diagnosed.    But the USPSTF maintains the benefits of testing are overrated. The task force recommends against prostate cancer screening using the PSA test as the potential benefit does not outweigh the harms said Dr. Michael LeFevre covice chair of the task force and professor in the department of family and community medicine at the University of Missouri School of Medicine.    As a result of treatments for PSAdetected prostate cancer one out of  men screened in the United States develops a blood clot in his legs or lungs two will have a heart attack or stroke and up to  are left impotent or with urinary incontinence LeFevre said.    At best only one of these  men who were screened avoids dying from prostate cancer for at least  years LeFevre said. In addition about one in every  men screened dies as a result of surgery to treat cancer detected by the PSA test.    Still the task force recognizes that some men may continue requesting the PSA test and some physicians may continue offering it LeFevre said.    Before getting this blood test  which measures a protein in cells of the prostate gland  men should learn about the pros and cons he said. The decision to start or continue screening should reflect an understanding of the possible benefits and known harms and should respect each individuals preferences.    Messing advises men with a family history of prostate cancer or urinary symptoms to have a PSA test. Men with no family history or symptoms should discuss PSA testing with their doctor he added.    Messing pointed out that screeningdetected cancer doesnt mean surgery chemotherapy or radiation treatment must follow. Most cases can be watched for some time he said.    Dr. Otis Brawley chief medical officer for the American Cancer Society said over the past few years a number of studies have been published on the benefits and harms of PSA testing.    None of these studies can be considered decisive other than in proving that there are some harms associated with treatment he said. The American Cancer Society still supports screening for certain men in consultation with a physician.    Prostate cancer is the secondleading cause of cancer death among men in the United States. In  more than  new cases are expected to be diagnosed and  men will die from the disease researchers say.  More information  For more information on prostate cancer visit the U.S. National Cancer Institute."