chris.booth@chaps.uk.com Bradley and colleagues’ editorial1 reiterates outdated uncertainties around prostate specific antigen (PSA) based screening for prostate cancer and fails to highlight advances in UK clinical practice.2 The editorial correctly points out that national guidance needs updating but cites recommendations from the UK National Screening Committee (NSC) and the United States Preventive Services Task Force (USPSTF). ...the USPSTF had to amend its advice in 2018 and this now parallels that of the NSC—a shared decision based on informed choice. Audit of PSA requesting practices in primary care compared to guidelines established by the Prostate Cancer Risk Management programme in the Avon region of the South West of England.