A 20-year long Swedish trial shows PSA screening doesn’t impact mortality. Prostate cancer can be deadly, but a new study has found evidence that getting screened for it doesn’t cut the chances of dying from the disease.

The study lasted 20 years and involved 9,026 Swedish men, from which 1,500 were randomly selected to be screened every three years for prostate cancer.

Participants received digital exams on the first two visits and the PSA test was added for the next two. The fourth and final screening involved only men aged 69 or under. Researchers found the rate of death between men with prostate cancer and men who were not screened was the same.

The new results aren’t likely to end the debate about routine screening for prostate cancer. Some believe screening leads to unnecessary biopsies and treatment that is not proven to save lives.

To test for prostate cancer, a physical exam and a PSA blood test and taken. A standard PSA blood test looks for high levels of prostate-specific antigen. This test is controversial because PSA levels can be high for a few reasons, meaning a positive result must be further confirmed by a biopsy. If the biopsy is also positive, there is no proven way to treat the cancer.

Many options exist to treat prostate cancer including surgery, hormone therapy, radiation or watchful waiting. However, the American Cancer Society does not recommend routine screening for most men. The Swedish Cancer Foundation and other groups paid for the study. It was published online in the journal BMJ.