KLK3 and Familial prostate cancer: Finally, with the growing body of evidence showing increasing rates of prostate metastasis and aggressive tumors due to lack or reduced applications of prostate cancer screening with PSA (2), we believe that our study is crucial to alert urologists and healthcare community to keep using digital rectal exam (DRE) and PSA as the standard option of prostate cancer screening, especially in countries relying on public health with restricted access to MRI exams and genetic tests.