Prostate cancer (PCA) is the most prevalent cancer among males. The National Institute for Health and Care Excellence (NICE) recommends referral to PCA diagnostic pathway based on two criteria: (1) abnormal digital rectal examination (DRE) and (2) elevated prostate-specific antigen (PSA). This study evaluates the diagnostic value of routine DRE in patients undergoing PCA assessment with pre-biopsy MRI. The gene discussed is KLK3; the disease is Familial prostate cancer.