Overdiagnosis of clinically trivial disease potentially leads to overtreatment and harm, whereas late diagnosis of potentially lethal disease is a major, and growing, cause of morbidity and premature death, particularly in low-income and middle-income countries (LMICs).1,5 Treatment of prostate cancer is determined by stage (ie, TNM tumour classification) and tumour grade (ie, Gleason grading), and also depends on PSA concentrations and the age and broader health of the patient. This evidence concerns the gene KLK3 and prostate cancer.