The ideal diagnostic test has been described as safe, accurate, available, and actionable and providing a favorable benefit-to-harm ratio.49,50 While PSA alone offers favorable practical attributes, its lack of cancer specificity has driven the need for a complementary test to improve screening outcomes.4 While prebiopsy mpMRI improves detection of high-grade cancer in men with positive findings on mpMRI,7,51 data describing the use of negative mpMRI findings to rule out significant cancer merit concern. Here, KLK3 is linked to cancer.