They concluded the current evidence is "insufficient to assess the balance of benefits and harms of the service. Evidence is lacking, of poor quality or conflicting, and the balance of benefits and harms cannot be determined."
For younger men, the available data "strongly suggests that PSA screening can save lives and, without a doubt, it has," said Eggener. Over the last two decades, the U.S. age-adjusted mortality rate from prostate cancer has decreased 40 percent.
"The decreasing death rate from prostate cancer is a great public health success story," Eggener said. "But you can't talk about that improvement without discussing the large number of men treated for prostate cancer that would never have otherwise caused them symptoms or problems during their life span."
A more sensible approach is to talk about the pros and cons of PSA screening and consider screening for men with a life expectancy of more than 8 to 10 years, since they are most likely to benefit, Eggener added.
Traditionally, nearly all men diagnosed with prostate cancer were treated, regardless of age or health.
Clinical research has shown, however, that not all prostate cancer needs to be treated aggressively or immediately after the diagnosis. A landmark study, for example, found that surgery is unneeded for most early-stage prostate cancer. Most men with this early-stage cancer will live just as long by monitoring their cancer, according to the study, published in the July edition of the New England Journal of Medicine.
At one time, the doctors who promoted this "active surveillance" strategy were considered fringe or renegade, but it has become increasingly common, Eggener said.
"It's not for every patient, but for appropriately selected patients it's a reasonable management strategy," he said.
It definitely wasn't for Cooper, who worried that his cancer would spread.
"Personally, if I have cancer in me, I don't want to let it go," he said. "I'd rather be proactive and take care of it than sit back and wait."
Eggener agreed that "PSA may indeed save your life." But he also cautions that men need to be aware of the possibility of being diagnosed with a cancer that will never cause symptoms or kill them.
What you can do
Read the review on prostate cancer at uspreventiveservice staskforce.org. Tell your doctor you've read it, and consider testing only if your risk is sufficiently high, suggested Hal Arkes, who studies why men continue to seek out the PSA even as controversy swirls around its worth.