In a community-led PSA screening programme in a high-risk predominantly Afro-Caribbean population in the Grand Bahamas, 315 of 1844 men screened had increased PSA concentrations or abnormal digital rectal examination results, or both.79 On the basis of these findings, 45 men were offered a biopsy, of whom 40 had prostate cancer (2·2% prevalence in the study population), mostly high-risk disease.79 In a study80 done at a centre in São Paulo, Brazil, 9692 men underwent PSA testing and digital rectal examinations, and 588 had abnormal findings. This evidence concerns the gene KLK3 and prostate cancer.