While the increasing trend in prostate cancer incidence in the early 1990s was most likely due to widespread use of prostate-specific antigen screening that led to case surge in detecting men with asymptomatic prostate cancer, the decreasing trend in 1991-2013 was most likely due to the reduced number of early (local) stage prostate cancer through PSA screening (1). This evidence concerns the gene KLK3 and prostate carcinoma.