Encouraging news from a recent Canadian study on prostate cancer is met in the United States with a hole in health care coverage that could prove fatal to some men. The lack of coverage for cancer screenings is likely to be the next big question for insurers, and it was given a big push recently from an unlikely source. It will be difficult for insurers that readily cover impotency cures — the Viva Viagra package — to not cover tests for the second-leading cause of cancer death for men.

Screenings for prostate cancer — called PSAs for prostate specific antigen, a marker in the blood — are controversial because they can suggest that no cancer is present when up to 30 percent of the time it actually is. Nevertheless, an eight-year study of 46,000 men in Quebec found that men who were invited to take PSA tests were substantially less likely to die of prostate cancer than those who were not. Critics say the study has problems in its methodology, but it is useful both for offering other researchers clues in reducing cancer deaths and as a means of highlighting the seriousness of prostate cancer.

One older man in 11 will get prostate cancer; more than 40,000 men in this country die from it every year, the second highest cancer death rate after lung cancer. Unlike some other forms of cancer, however, prostate cancer may either spread quickly or grow very slowly. The slow-growing type, thought to be the majority of cases, can be present for many years without spreading to other parts of the body or affecting health.

If substantiated by other studies, the Quebec report will prove important because it will have shown for the first time that PSA screenings are effective in reducing the number of deaths from prostate cancer. That will help organizations such as the National Cancer Institute and members of the insurance industry overcome their reluctance to recommend PSAs.

So will solving a second question: what to do with information PSAs provide. Sometimes the treatment for slow-growing prostate cancer is more dangerous than the cancer itself, according to some doctors. But the confusion over whether to simply watch the cancer, use radiation treatment or perform surgery is not the fault of the PSA. A wider education effort should help patients make better-informed choices.

Meanwhile, many older men who could benefit from having a PSA go without because it is not covered by insurance.