Additional non-genomic considerations include the elevated clinical heterogeneity observed across ethno-linguistic groups from the same region within sub-Saharan Africa59,60, while defining high- or very-high-risk PCa based on European-derived NCCN PSA inclusion criteria (PSA > 20 ng/mL) for PCa GT screening, as shown for SAPCS21, requires African-specific criteria. This evidence concerns the gene KLK3 and posterior cortical atrophy.