KLK3 and urogenital neoplasm: However, clinical PSA measurements exhibit substantial variability, as PSA levels can significantly fluctuate due to various factors, whether intrinsic to the patient -such as elevations due to benign prostatic hypertrophy, recent manipulation of the prostate due to massage or biopsy or prostatitis (Pezaro et al., 2014; Tzelepi 2023; Maeda-Minami et al., 2023)- or external.