Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of screening with their clinician and to incorporate their values and preferences in the decision’;9 however, the tools to achieve this are largely unavailable in both the US and UK, and such shared decision making is seldom undertaken.8 A recent BMJ rapid review, which summarised all the available evidence on prostate cancer screening with PSA tests, highlighted the need for research to test risk-stratified approaches.8 This evidence concerns the gene KLK3 and Familial prostate cancer.