A 44-year-old healthy man was referred for assessment of high PSA levels by his GP. He had no significant medical/family history and his examination was unremarkable. His PSA was 3.5 ng/ml being 3 ng/ml six months earlier.

A 50-year-old healthy farmer was seen for his annual medical by his GP. His family history was significant for breast cancer in his sister. After discussion about risks and benefits of prostate cancer screening he had a digital rectal examination (DRE) which revealed a small firm nodule.