KLK3 and Familial prostate cancer: Following the introduction of prostate-specific antigen (PSA) testing in the United States (US), fatal prostate cancer incidence declined between 1995 and 2002 at an average rate of 5% per year.1 Defined as death from the disease within 10 years of diagnosis, ‘fatal prostate cancer’ represents a non-indolent subset of the disease that is less sensitive to lead time bias in descriptive epidemiology studies2 and allows investigators to better track incidence trends alongside contemporary clinical practices.