Indeed, the overall AUC for PSAd was significantly better compared to PSA alone for both any cancer (0.71 vs 0.61) and csPCa (0.78 vs 0.69; both p < 0.0001; Table 5) and again mirrored older pre-MRI studies on better PSAd performance as a diagnostic test.25–27 In terms of PPV, PSAd did improve upon PSA especially at higher PSAd thresholds (PSAd ⩾ 0.10 and ⩾ 0.15) with less of an effect in poorer NPV (Table 6). This evidence concerns the gene KLK3 and cancer.