Prostate cancer is diagnosed in 37 000 new patients a year, and causes 10 000 deaths each year in the UK (Cancer Research UK, 2011). Diagnoses are increasingly the result of screening using measurement of prostate- specific antigen levels. The natural history of early disease is unclear. Autopsy studies before prostate-specific antigen screening showed an actual latent prevalence (not diagnosed during life) of around 30% at the age of 50 years and 75% at the age of 80 years, and many of these demonstrated local invasion (Franks, 1954). One of the main current challenges in urology is distinguishing indolent prostate cancers from potentially lethal ones. The specificity of the prostate-specific antigen test for clinically significant disease remains disappointingly low and population screening is not encouraged (Ilic et al, 2011). However, prostate-specific antigen testing is often done in good faith, but pre-test counselling is essential. Thus, prostate-specific antigen testing should only be undertaken by the patient's GP or on the advice of a urologist.