The task force acknowledged that "some men will continue to request screening," but said doctors "should not offer or order" it unless they first "engage in shared decision-making that enables an informed choice by the patients."

Urologists and advocacy groups immediately decried the advice - as they did when a draft version was released last October - and worried that insurers may stop paying for PSA testing.

But other experts applauded the unflinching recommendation, pointing out that screening dilemmas have already led the medical community to turn away from automatic PSA testing. Even the American Urological Association recommends that testing be "individualized" and that men be informed about the risks of over-detection and overtreatment.

The association nonetheless on Monday condemned the blanket rejection of screening as "inappropriate and irresponsible."

One of the most vocal critics of routine testing - Richard J. Ablin, 72, who discovered the prostate-specific antigen in 1970 - was jubilant. For decades, he has said that using the blood protein to try to flag cancer in the reproductive gland is "hardly more effective than a coin toss." He says the test should be reserved for monitoring prostate cancer patients for recurrence after treatment.

"I'm thrilled that I lived to see this," said Ablin, an immunobiologist at the University of Arizona College of Medicine. "For 38 years I was called a wacko" for saying the PSA test was being misused.

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Recommendation against prostate screening shakes medicine