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Prostate cancer is the second-leading cause of cancer death among men in the United States and in 2012, researchers say more than 240,000 new cases are expected to be diagnosed, and 28,000 men will die from the disease. 

There has been much debate about whether prostate-specific antigen (PSA) testing for prostate cancer is an effective screening method. Now, new research has revealed that not screening would triple the number of U.S. men developing advanced cancer.

The report was published online July 30 in the journal Cancer.

Researchers say testing could keep about 17,000 men each year from receiving a diagnosis of late-stage prostate cancer -- cancer that has spread and is far less curable. 

Researchers compared information from the U.S. Surveillance, Epidemiology, and End Results database for the years 1983 to 1985, immediately before widespread PSA testing started, to data from 2006 through 2008.

In the 2008 data, 8,000 cases of prostate cancer were diagnosed after the malignancy had spread to other parts of the body. A model developed by researchers showed that instead of 8,000 actual cases in 2008, about 25,000 cases would have been diagnosed.

"Our findings are very important in light of the recent controversy over PSA testing," said Edward M. Messing, M.D., study co-author, chair of Urology at URMC, and president of the Society of Urologic Oncology. "Yes, there are trade-offs associated with the PSA test and many factors influence the disease outcome. And yet our data are very clear: not doing the PSA test will result in many men presenting with far more advanced prostate cancer. And almost all men with metastasis at diagnosis will die from prostate cancer."

As a result of treatments for PSA-detected prostate cancer, one out of 1,000 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 40 are left impotent or with urinary incontinence. 

The annual number of prostate cancer deaths dropped from about 42,000 in the 1990s to 28,000 now. 

The researchers say the study was observational and has some limitations because it is impossible to know if the PSA test and early detection is solely responsible for the fewer cases of metastasis at diagnosis in 2008.

The U.S. Preventive Services Task Force (USPSTF) in May recommended against routine PSA screening, saying too many non-lethal cancers were being treated aggressively, exposing men who didn't need treatment to serious side effects such as impotence and urinary incontinence.