Additionally, strategies applying a fixed PSA cutoff of 4.0 ng/mL detect slightly more PCa cases than strategies using age-specific cutoffs and identify slightly more metastatic cases at initial detection (e.g., fixed PSA cutoff = 4.0 vs. age-specific PSA cutoffs, 45–74 years, annually; incidence 857.94 vs. 819.47 per 100,000; metastasis 9.18 vs. 9.26 per 100,000). This evidence concerns the gene KLK3 and posterior cortical atrophy.