Subclinical prostate cancer is common in men >50 years Population-based screening of men aged between 55 and 69 years, using prostate-specific antigen (PSA) testing, has been evaluated.1 After a median follow-up of 16 years, the European screening trial demonstrated a 25% relative reduction in prostate cancer mortality. However, 570 men needed to be invited for screening and 18 patients needed to be treated to prevent one death from prostate cancer, and there was no effect on overall survival (OS). Risk-adapted early detection of prostate cancer using a baseline PSA has been evaluated in retrospective cohort studies. Men with a PSA >1 ng/ml at 40 years or >2 ng/ml at 60 years are at increased risk of prostate cancer metastasis or death from prostate cancer