We found that: (1) BPH/PV PRS was significantly and independently associated with PCa death; (2) known PCa-related PRS (PRACTICAL PRS and PHS) could distinguish individuals’ PCa risk but failed to predict PCa patients’ natural outcome; and (3) Only the P/LP mutations in BRCA2 or PALB2 were found to be associated with PCa death in this cohort and did not interact with BPH/PV PRS. Here, BRCA2 is linked to posterior cortical atrophy.