A recent screening PSA of less than 1 ng/mL selects an extraordinarily low-risk population with a less than 1.00% 10-year risk of undergoing prostate biopsy, a diagnosis of clinically significant prostate cancer, and prostate cancer treatment; less than 0.15% risk of mPCa; and less than 0.10% risk of PCSM. This evidence concerns the gene KLK3 and Familial prostate cancer.