A panel of experts has released a draft recommendation that men aged 55 to 69 with no sign of prostate cancer should still talk to their physicians about whether they should be screened for the second leading cause of cancer deaths in American men.

The U.S. Preventive Services Task Force issued a contentious recommendation in 2012 leaning against screening among men of average risk because of the substantial potential harms associated with screening and treatment.

Prostate cancer screenings are done using a blood test that measures the amount of a prostate-specific antigen, a type of protein, in a man’s blood. When a man has elevated PSA, it may be caused by prostate cancer, but it could also be caused by other conditions such as inflammation of the prostate.

One of the challenges of prostate cancer is that a substantial proportion of prostate cancer grows so slowly that it would not harm the patient.  The task force found that detecting prostate cancer early might not reduce the chance of dying from the disease and that treatment often caused impotence and urinary incontinence.

But now the task force members, using new data from a European trial and evidence about current treatment practices, believe there is more evidence to suggest the benefits of the screening might outweigh the harms for certain men — and that the choice should be one made with their physicians.

“The benefits and harms of prostate cancer screening are closely balanced and our new draft guideline suggests that men discuss screening with their physicians,” said Stanford Health Policy’s Douglas K. Owens, who was a member of the task force during the development of the guideline.

“We now have a long-term follow-up from clinical trials that show modest benefits and more men are being treated with active surveillance which may mitigate some of the harms of overtreatment,” said Owens.

Some 181,000 men in the United States are diagnosed with prostate cancer each year. Of those, an estimated 26,000 men die from the disease.

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The task force changed its draft recommendation for screening from a D to a C for men aged 55 to 69, but continues to recommend against men 70 and older being screened. The draft recommendation is open for public comment through May 8 on its new prostate cancer screening website.

“Prostate cancer is one of the most common cancers to affect men, and the decision about screening using PSA-based testing is complex,” said Task Force Member Alex H. Krist, MD, MPH. “In the end, men who are considering screening deserve to be aware of what the science says, so they can make the best choice for themselves, together with their doctor.”

The Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive serves such as screenings, counseling services, and preventive medications.

Task Force Chair Kirsten Bibbins-Domingo, PhD, MD, said members reviewed evidence on the benefits and harms of screening for men at higher risk for prostate cancer, such as African-American men and those with a family history.

“Clinicians should speak with their African-American patients about their increased risk of developing and dying from prostate cancer, as well as the potential benefits and harms of screening,” said Bibbins-Domingo.

She noted that there remains a “striking absence” of evidence to guide high-risk men as they make their decisions about screening: “Additional research on prostate cancer in African-American men should be a national priority.”

Many national medical associations are aligned with the task force’s new recommendations, including the American Urological Association, the American Cancer Society and the American College of Physicians.

Some critics continue to have concerns about screening.

“In my mind, the greatest misconception about the test is that we say it ‘saves lives,’ when that is uncertain,” writes Vinay Prasad, an oncologist, in the popular medical blog, STAT News. “PSA testing reduces the risk of dying of prostate cancer, but there is no evidence it reduces the risk of dying,”

If there is such a person as a universally respected and universally loved scholar, Professor Arrow was such a man. I have been trying to think of what I might write to pay tribute to him that somebody else could not say better.  I will give it a shot, though I am not qualified to do this task full justice.

Prof. Arrow was a great genius whose work will be spoken about for as long as economics remains a subject of interest. But I am sure that other economists, even someone who did not know him personally, could do an excellent job of recounting his genius. At the very least, Prof. Arrow’s impossibility theorem and his groundbreaking work on general equilibrium models will be part of the standard curriculum of economics, I believe forever. He had an incredibly wide-ranging curiosity, which led him to work that has revolutionized many empirical fields, including my field of health economics.

Let me focus instead on Prof. Arrow’s reputation for being a kind and humble man, about which I can give some specifics. The main thing I have to say about this is that his reputation was well deserved. There are many stories I could tell, but I’ll just tell one here.

In 1989, during the fall of my senior year in college, Prof. Arrow offered a class on economic inequality for undergraduate economics majors. To my surprise, the class was not oversubscribed, and so I signed up. Prof. Arrow was quietly brilliant the whole quarter. In his hands, the economics of inequality touched on an astonishing array of topics, and to this day, I cannot think about the subject except with the framework he presented there.

He was not an outstanding speaker – there was nothing flashy about his style, but there was nothing false either. His aim as a teacher was to focus his students on the material, not himself. Even when he presented his impossibility theorem, I do not remember him saying that it was his theorem.

The next part is embarrassing. The impossibility theorem says, very roughly, that in a society where there is broad disagreement about social policy, democratic processes can produce incoherent social outcomes. When Prof. Arrow taught it in the class, however, I misunderstood and thought the theorem said that democratic processes always lead to incoherent social outcomes. That evening, I found an easy – too easy! – counter-example to the incorrectly understood theorem. So I scheduled a time to go meet with Prof. Arrow to see where I had gone astray.

When we met, Prof. Arrow was very kind as he explained my error. He even apologized for being unclear in his explanation, even though I am sure most of the rest of the class had it right.

He spent the bulk of the time that day trying to find out what I wanted to do with my life. When I told him I wanted to be a doctor and not an economist, he seemed disappointed (this genuinely surprised me) and he encouraged me to think some more about it. That meeting led me for the first time to think really seriously about a career as an economist. That brief meeting with Prof. Arrow changed my life.

It is easy to be sad when someone of Prof. Arrow’s character and genius dies. I am grateful that I had the opportunity to get to know him. I will always count his touch on my life a blessing from God and I will miss him.