In this study, we assessed fatal prostate cancer incidence through comparisons of geography (United States vs. England), race (black vs. white), and initial treatment (RP) for the period 1995–2005; the selected time period follows the introduction of PSA screening and the depletion of a prevalent disease reservoir in the US, thus allowing us to examine trends that are unobscured by large fluctuations in PSA testing. This evidence concerns the gene KLK3 and prostate cancer.