While patients diagnosed with PCa at a young age are evidently at risk for high penetrance pathogenic germline mutations such as BRCA1/218 or HOXB1319, predicting earlier age of onset based on multiple variants with small effect size potential have produced ambiguous results, with a previous study20 finding a PRS of 24 SNPs to be discriminatory for any and high grade GG ≥ 2 PCa only between age 60–70 years, losing predictive value in younger patients, most likely due to low prevalence and high likelihood of low-grade disease in this age group. Here, BRCA1 is linked to posterior cortical atrophy.