"If youre wondering why experts still cant agree on prostatecancer screening youre not alone. Just two months ago a major U.S. government panel said that basically no one should get screened for prostate cancer httphealthland.time.commenshouldforgopsatestingforprostatecancerpaneladvises claiming the simple blood test for prostatespecific antigen or PSA does more harm than good. Now a new study looks at government data httphealthland.time.comprostatecancerscreeningwhycantdoctorsagreeseer.cancer.gov and finds that without PSA testing the U.S. would have three times as many patients each year diagnosed with advancedstage prostate cancer  and the vast majority of those cases would be fatal. Almost all men with clinically apparent metastases at initial diagnosis will die from prostate cancer urologist and study author Edward Messing told reporters as he explained the importance of his study. The new study reflects a broader divide in the medical community between public health experts who have largely turned away from PSA screening and many practicing clinicians who feel the test has helped their patients immensely. MORE Men Should Forgo PSA Testing U.S. Panel Advises httphealthland.time.commenshouldforgopsatestingforprostatecancerpaneladvises No one denies that PSA tests can help to catch prostate cancer early. But two issues are still unresolved. One is how well screening can actually work to prevent cancer deaths the other is what kind of negative effects screening brings httphealthland.time.comwhencancerscreeningdoesmoreharmthangood along with its benefits. On the first issue there is still some uncertainty. In the U.S. a large randomized trial found no mortality benefit http of screening. But an even larger randomized clinical trial in Europe http has found a benefit. In its latest results http published this spring the European study team said that men who undergo routine testing have significantly lower risk of prostatecancer death after  years. Still the real crux of the debate on PSA testing is the second issue the possible negative effects of screening. No diagnostic test is  accurate and if a PSA test comes back positive for prostate cancer the patient will usually be referred for a biopsy to confirm the diagnosis. That test can have side effects. Then if the patient does have cancer  the available treatments http for it  surgery radiation as well as other options  also have side effects chief among them impotence incontinence and urinary incontinence. The same European trial that found lower cancer mortality with PSA testing also found that to save just one life through screening an extra  men would need to be diagnosed with prostate cancer and treated http Many health experts think thats too much risky treatment to justify the results. So when the government advisory panel  the U.S. Preventive Services Task Force  recommends against routine PSA testing its making a judgment call. Its saying that for most men the albeit small risk of sexual dysfunction and urinary leakage from eventual treatment is not worth it given the even smaller chance that PSA testing could save your life. But that decision does remain a judgment call. It depends on how much you value certain qualityoflife measures versus how much you value having any life at all. MORE Surgery for Early Prostate Cancer Doesnt Save Lives httphealthland.time.comstudysurgeryforearlyprostatecancerdoesntsavelives As for the new paper this week which suggests that three times as many men would be diagnosed each year with metastatic prostate cancer if it werent for PSA testing that study is published in the journal Cancer  and its numbers deserve a little explanation. To calculate the total number of metastatic cases wed get without screening the study takes todays population of the United States and applies the rates broken down by age and race of advancedstage prostate cancer that were observed before PSA testing was introduced  that is the rates way back in . In other words it tells us what the current U.S. population would look like if today we faced the same risks that Americans faced in the s it finds wed have roughly  U.S. men diagnosed with advancedstage prostate cancer each year compared to just  today. But is going back in time  years really the same thing that wed get if we abolished PSA testing today Who knows The rate of new diagnoses of all cancer types combined has been falling consistently http in recent years. However prostate cancer is one of the few cancers thats not strongly linked to smoking http and falling cigarette consumption over the past  years is a major reason for falling cancer rates. It is however linked to obesity which has been on the rise since the s. One further fact to keep in mind is that PSA testing works to cut the number of newly diagnosed advancedstage cancers  but it does so by increasing the number of cancers that are caught early. And as the debate over PSA testing shows us early diagnosis is only useful if early treatment can help patients live longer and healthier lives preventing progression to advancedstage cancer down the line but without increasing the risks of other health problems too much in the process. Thats what experts cant agree about. Many doctors do have very strong opinions though. As a patient if youre deciding whether to get a PSA test or whether not to get a PSA test remember you do have a right to your own opinion too. Theres no easy answer. MORE Prostate Cancer Screening What You Need to Kno httphealthland.time.comprostatecancerscreeningwhatyouneedtoknow"