Prostate cancer screening doesn’t necessarily save lives, according to the first news out of a pair of high-profile research studies released this month, but urologists still see plenty of utility in PSA testing.

The blood test for protein-specific antigen, or PSA, is widely used to screen men in the United States for the most common cancer found in men here and in Europe.

A study of more than 75,000 American men found that while the blood screening detected more prostate tumors, there was no appreciable difference in the number of cancer deaths.

In a study conducted in the Netherlands — where the testing is less common — about 162,000 men were offered screening every four years or not at all, and the PSA test was found to lower the prostate cancer death rate by 20 percent. To save one life, the researchers said, would take screening 1,000 men and treating 48.

“It doesn’t really settle the issue,” said Dr. Gedas Grinis, a urologist at Aurora Medical Center in Kenosha. “There are reasons to do the test and reasons not to.”

Both studies conclude that more diagnosed cancers do not necessarily mean a better result for the patients. Prostate cancer is generally slow-moving, often taking a decade or more after diagnosis to develop into a serious threat or spread to other parts of the body. Because the cancer causes few symptoms before spreading, the cases doctors used to discover were often fairly advanced, according to Dr. Meredith Clubb, a urologist practicing in Kenosha for more than 30 years.

“It used to be 80 percent of the men diagnosed had metastasized,” Clubb said. “We had relatively few men who were diagnosed before the cancer spread. That has flip-flopped. It’s rare to see a metastasized cancer now.”

While the new studies discount the role of PSA testing in that shift, Clubb and Grinis are skeptical of the conclusions.

“Is it because people are more aware, or because they get PSA tests? We can’t say,” Grinis said. “But it’s uncommon for a disease to get better unless something is done.”

The researchers weighed the benefit of the extra tumors discovered against the effects of treatment. The surgery, radiation and hormone therapy used to combat prostate cancer can lead to impotence and incontinence. Both studies noted a high incidence of treatment of cancers that were not life-threatening, unnecessarily extending the potentially life-altering side-effects of treatment to more men.

But treatment is changing so fast — and with apparent significant improvement in quality of life for patients — that Grinis said it is hard to conclude whether the cancer is over-treated.

“The best we have is an educated guess,” he said. “There’s no test that says, ‘This one is a tumor you can ignore.’ There is a discussion to have with each patient.”

Both urologists recommend annual PSA screening for men ages 50 and older. For black men and men with a family history of prostate cancer, they say begining the testing at 40 makes sense. There is little agreement among medical organizations on such guidelines, and at least a few warn against using the PSA altogether.

“They think it’s inconclusive and just scares people,” Grinis said.

The Kenosha physicians think otherwise — pointing out the test’s utility in monitoring changes over many years, like following the blood sugar of a diabetic person — as long as the PSA is done in conjunction with a physical test and seen only as one tool among several. The monitoring often is called “watchful waiting.” Clubb said PSA screening may be useful in a similar process he called “expectant observation,” in which a cancer is diagnosed, but treatment can be put off until indicators (like PSA scores) show significant changes that could precede metastasis.

Even so, Clubb said patients tend to put too much weight on the result of the PSA test.

“In America in general we like to measure things — touchdowns, home runs, blood pressure,” he said. “People focus on the number without taking it in context.”

He has seen a shift in the last 20 years to tumors that appear less severe according to a scoring matrix drawing on a number of diagnostic factors.

“The question is, do all those men have to be treated? And the answer is no,” Clubb said. “But some patients, they want the cancer removed no matter what. Others say, ‘Do anything but surgery,’ or, ‘No radition. I had a friend who had a bad experience with radiation.’”

The new research findings won’t change substantially the way either doctor uses the PSA, though they said combination of slow progression and the treatment’s side-effects will make them less likely to recommend screening for older patients.

“If you’re 75, 80 years old, and you haven’t had any problems yet, it might not really matter anymore,” Grinis said.