Tests which are unlikely to be followed up by biopsy, and which are undergone by older men, are likely to be guiding the treatment of benign hyperplasia of the prostate.12 Guidance for the assessment of lower urinary tract symptoms (LUTS), affecting approximately 30% of men over 50s,13 includes consideration of a PSA when LUTS are suggestive of bladder outlet obstruction secondary to benign prostatic enlargement; where PSA >1.4 ng/mL can direct drug treatment decisions.14 This evidence concerns the gene KLK3 and benign prostatic hyperplasia.