The difference between the PPVs of PSA and tCEC test was significant for the primary endpoint (all PCa) (32% vs. 54%, general estimating equation (GEE) model odds ratio 2.47 (95% CI 1.43–4.24); p = 0.0011), as well as the secondary endpoint, primary definition (Gleason 3 + 4) (17% vs. 32%, GEE model odds ratio 2.25 (95% CI 1.38–3.68); p = 0.0012) and secondary definition (Gleason 4 + 3) (10% vs. 18%, GEE model odds ratio 1.93 (95% CI 1.09–3.40); p = 0.0012). This evidence concerns the gene KLK3 and posterior cortical atrophy.