SHBG and pachyonychia congenita: The performance of the risk classifier was evaluated through a multi-stage approach (Fig. 2): (1) Baseline model initiated with PSA, (2) Enhancement with laboratory biomarkers significantly associated with PC risk (Androstenedione, free PSA%, DHEA-Sulfate, and SHBG), (3) Integration of clinical factors (Age, family history, DRE results, prostate volume, and PSAD), (4) Integration of MRI results (PIRADS scores) and (5) Advanced baseline model with solely PSA and MRI as comparison.