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. This evidence concerns the gene KLK3 and prostate cancer.