LOS ANGELES -- New guidelines for prostate cancer screening issued Wednesday emphasize that physicians should better educate men about both the risks and benefits of using the PSA test for screening.

They also call for cutbacks in the use of digital rectal exams to find tumors and recommend the end of mass prostate screening programs at health fairs and other sites.

The revised guidelines issued by the influential American Cancer Society come on the heels of several studies suggesting that large numbers of tumors identified by PSA screening are inconsequential and that biopsies and treatment produce more harm than those tumors would.

Because of such findings, the new guidelines emphasize the importance of physicians explaining both risks and benefits to the patients more fully so that each man can make an informed decision about whether to get tested.

Perhaps recognizing that physicians are unlikely to invest greater amounts of time in such educational efforts, however, the society also urged greater use of education specialists, pamphlets, videos and other materials to explain the risk-benefit tradeoffs. The panel that issued the guidelines called for cutbacks in community screening programs precisely because such educational efforts are rarely, if ever, incorporated.

And the group downplayed the importance of digital rectal examinations -- unpleasant procedures that were once a mainstay of physical exams for men over 50 but which have become less common in recent years -- because of lack of evidence that they save lives.

Otis W. Brawley, chief medical officer of the American Cancer Society, said the new guidelines are not that different from earlier ones issued in 1997 and 2001.

"I think (earlier panels) meant to say what we are saying now, but they were interpreted by people to say we were encouraging screening," Dr. Brawley said. "They were trying to encourage informed decision making."

S. Adam Ramin, a urological oncology specialist at St. John's Health Center in Santa Monica, Calif., said that the ACS guidelines place too much emphasis on whether the tests save lives and not enough on whether they prevent complications from tumors, such as leaking of urine, incontinence, bone pain, anemia and weight loss.

"Although it is true that treatment will not necessarily save a lot of lives, it does prevent complications," Dr. Ramin said.

But other experts noted that treatment itself can produce complications such as urinary incontinence and impotence.

Skip Lockwood, president of Zero: The Project to End Prostate Cancer, said that calls to end the digital rectal exam are "kind of nuts. ... The whole concept that you would do anything to reduce the amount of information you have does not make sense to me."

He said his organization would continue its mass screening programs with PSA tests, which have now tested more than 100,000 men. Most of the people tested by the organization don't have doctors to provide the tests, he said, and "even the guys with doctors don't talk to them."

Prostate cancer is the most common cancer in men after skin cancer, affecting 192,000 men each year and killing 27,000. And while all the parties may not totally agree on how and how often PSA screening should be used, they are in unanimous agreement on one point. As Mr. Lockwood said, "We need a better test."

Washington correspondent Daniel Malloy writes the "Pittsburgh On The Potomac" blog exclusively at PG+, a members-only web site of the Pittsburgh Post-Gazette. Our introduction to PG+ gives you all the details.