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We appreciate the informative comments about our report. In Korea, a prostate-specific antigen (PSA) level of ≥4 ng/mL is considered an indication for prostate biopsy. However, many investigators have reported a high prevalence of prostate cancer at lower PSA cutoffs. Most of these cancers were found to have pathologic features consistent with clinically significant disease. Catalona et al 1 Catalona W.J. Smith D.S. Ornstein D.K. Prostate cancer detection in men with serum PSA concentrations of 2.6 to 4.0 ng/mL and benign prostate examination: enhancement of specificity with free PSA measurements. JAMA. 1997; 277: 1452-1455 Crossref PubMed Google Scholar reported that prostate cancer was detected in 73 (22%) of 332 men who had undergone biopsy with a PSA level of 2.6-4.0 ng/mL and normal prostate examination findings. Of the patients who underwent radical prostatectomy, 81% were found to have organ-confined disease, and only 17% had tumors that were possibly harmless, as determined by the cancer volume and tumor grade. Schroder et al 2 Schroder F.H. van der Maas P. Beemsterboer P. et al. Evaluation of the digital rectal examination as a screening test for prostate cancer: Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst. 1998; 90: 1817-1823 Crossref PubMed Scopus (261) Google Scholar evaluated prostate cancer diagnosed by screening men in the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. Approximately 50% of the cancers detected at a PSA level of <4.0 ng/mL had aggressive features. Re: Kim et al.: Detection Rates of Nonpalpable Prostate Cancer in Korean Men With Prostate-specific Antigen Levels Between 2.5 and 4.0 ng/mL (Urology 2010;76:919-922)UrologyVol. 77Issue 4PreviewAlthough the serum prostate-specific antigen (PSA) level has been accepted as 1 of the 3 tools for prostatic cancer screening (along with the digital rectal examination and transrectal ultrasonography), the actual value of the early detection of prostate cancer in the elderly is still a subject of debate. The diagnosis of preclinical disease with the probable lower propensity for clinical progression could have resulted in the performance of a more radical prostatectomies than absolutely necessary within the screened population. Full-Text PDF