In the UK, around 12,000 men will die from prostate cancer in 2022 and 55,000 men will be diagnosed with the disease. Prostate cancer is the most commonly diagnosed cancer in men, accounting for 30% of all new cancer diagnoses, and the second leading cause of cancer death in this group. British black men are two to three times more likely to get advanced prostate cancer and twice as likely to die from the disease compared to white men. A similar pattern of inequality is observed in the United States. Autopsy studies show that many men die of prostate cancer rather than prostate cancer, with latent disease identified in approximately 20% of men at postmortem. This finding highlights a central problem in prostate cancer screening: identifying potentially fatal and treatable disease while avoiding overdiagnosis of incidental cancer.