In America, thousands of men get prostate biopsies after getting a PSA (prostate specfic antigen) test that registers over 4.0. Problem is, 80% of the biopsies show no cancer which is means that the test was highly non-specific, which quite high for any type of procedure. Because this is an invasive procedure, having an 80% failure rate is unacceptable. There is an alternative.
If your PSA is between 4-10, and you are over the age of 40 a free-PSA is the next step and should become the standard of care. If you are under 40 and your PSA is over 2, all bets are off and there may be a need for a biopsy. PSA comes in two types, one is bound to proteins, the other is free.
The higher the percentage of free-PSA, the lower the likelihood that there is prostate cancer present. If the free-PSA is under 10%, then there is a high likelihood of cancer. If it is over 25%, there is a 5% chance that it is cancer if you are between 40-64 and 9% if you are between 65-75.
If your doctor insists on doing a biopsy before doing a free-PSA and you fit in the categories above, find another doctor.