Prostate cancer is the most common cancer in men. More than 35,000 new cases are diagnosed annually and almost 10,000 men die each year in the UK from this disease.  Now an increasing majority of patients present with an isolated increase in prostate specific antigen (PSA). In the USA, where PSA testing is widely adopted, the death rate from prostate cancer is falling four times faster than in the UK. [With external links to the evidence base]