Compared with White men, African American men were 4% more likely to have high-grade Gleason scores (≥4 + 3) (adjusted odds ratio, 1.04; 95% CI, 1.00-1.07), 92% more likely to have PSA levels higher than 20 ng/mL (adjusted odds ratio, 1.92; 95% CI, 1.82-2.02), and 21% more likely to be diagnosed as having high-risk PCa (adjusted odds ratio, 1.21; 95% CI, 1.16-1.25) (eFigure 2 in the Supplement). This evidence concerns the gene KLK3 and posterior cortical atrophy.