Within the Riskman approach, prostate-specific antigen (PSA) was a significant predictor of both any prostate cancer (OR: 1.153; 95% CI: 1.124–1.183) and clinically significant disease (OR: 1.158; 95% CI: 1.117–1.200), while a lower percentage of PSAft% was associated with a reduced likelihood of both outcomes (Grade Group ≥ 1: OR: 0.585; 95% CI: 0.492–0.697; Grade Group ≥ 3: OR: 0.467; 95% CI: 0.310–0.703). Here, KLK3 is linked to Familial prostate cancer.