High-quality studies have now shown a role for mpMRI prior to biopsy in men at risk of prostate cancer due to a raised PSA or abnormal DRE.6 7 Based on these data, in April 2018, NHS England defined the best timed prostate cancer diagnostic pathway as using MRI before a biopsy decision in all men fit for radical treatment.16 In 2019, NICE guidelines recommended that men with a negative MRI can choose to avoid immediate biopsy.17 Some European and US guidelines now also advocate for MRI prior to biopsy.18 19. The gene discussed is KLK3; the disease is Familial prostate cancer.