The urological community has the obligation to grasp every means to reduce mortality from urological cancers. Prostate cancer is the most frequent male cancer and is the second most lethal cancer in men in an increasing number of countries. The disease has a particularly long palliative period with a huge impact on quality of life and healthcare costs. The simple PSA blood test has enormous potential as it reflects prostate gland activity. It may be used to detect prostate cancer in an early stage when it can still be cured. Although it leads to a higher diagnosis rate, it has been shown to significantly reduce cancer mortality and metastasis rates. PSA for early detection of prostate cancer is currently poorly used, both on an individual level, as well as early detection or screening for prostate cancer. To have most men worldwide benefit from the advantages of early detection of prostate cancer and to minimize the side effects, we need to act now to improve early detection protocols with new developments. The data from randomized trials should be updated with findings from studies analyzing a sub-step of the screening model.