In order to identify men who are most suitable for prostate biopsy, there is a need to identify a group at high risk, not just of prostate cancer, but of significant prostate cancer. Several large studies have analyzed the clinical characteristics associated with the finding of higher grade (usually defined as Gleason score ≥7) prostate cancer on biopsy. Factors significantly associated with high grade cancer were: PSA level, smaller prostate volume, abnormal DRE findings, age, and black African and black Caribbean ethnicity, whereas a previous negative prostate biopsy reduced this risk. A false-positive PSA (or a PSA ) has consequences, firstly the collateral effects or complications of a prostate.
