Despite the proven benefit of prostate cancer screening by the European Randomized Study of Screening for Prostate Cancer (ERSPC),1 policymakers do not recommend prostate cancer screening because of its related overdiagnosis: a fair point when it comes to a purely PSA-based screening algorithm as was applied within the ERSPC. However, the use of PSA, as the only selection tool for prostate biopsy, resulting in substantial overdiagnosis, is long out of date, and with it the argument of overdiagnosis to plea against prostate cancer screening. The latest considerations of the European Council on screening date from 2003 and did not support a programme for prostate cancer.2 Since those last eighteen years, and actually already three decades after the ERSPC started, new technologies have emerged such as multivariable prediction models (i.e. risk calculators) and magnetic resonance imaging (MRI). These tools build on the successes and failures of PSA. Also since the recommendations against prostate cancer screening, the incidence of advanced and metastatic prostate cancer continues to increase.3,4