Widespread prostate specific antigen (PSA) testing results in detection of prostate cancer 4-6 years earlier than possible with digital rectal examination. Twenty to thirty percent of prostate cancers detected with PSA testing (non-palpable disease) are small tumors (< 0.5cc) that may be unimportant in some men. Pre-treatment criteria that include PSA density and prostate biopsy findings provide the means to assess the significance of prostate cancer after diagnosis. This information is useful when counseling men regarding management options for non-palpable, PSA detected prostate cancer.