From 2010 to 2015, there was a decrease in the incidence of localized prostate cancer and an increase in the incidence of metastatic prostate cancer among men aged 50 years or older.24 Thus, we would expect that changes to PSA screening recommendations may have been associated with the higher rates of metastatic disease that we described herein. The gene discussed is KLK3; the disease is metastatic prostate carcinoma.