KLK3 and Familial prostate cancer: The VCP was enacted at a time when professional organizations began issuing guidelines that advised against aggressively treating clinically insignificant prostate cancer, as defined by early clinical stage, low Gleason score, and low prostate-specific antigen (PSA) level.4,5 While these changes represent a step toward decreasing the risks of overdiagnosis and overtreatment, implementation of these changes in clinical practice has varied by region and health care system.6,7