The higher uptake of 68Ga-PSMA-11 found in primary prostate carcinoma of black South-Africans when normalized for Gleason core, reflecting PSMA expression and biological activity, may in part explain the more aggressive behavior of prostate carcinoma in black men when compared with white men; respectively, a disproportionate reported advanced disease and a two- to three-times higher mortality from prostate carcinoma in black African men when compared to Caucasians [1–5]. This evidence concerns the gene FOLH1 and prostate carcinoma.