Genetics and Screening in Prostate Cancer.

Prostate cancer is a highly prevalent and heritable malignancy with marked disparities in incidence, stage at diagnosis, and mortality among minority populations. While localized disease carries an excellent prognosis, outcomes decline sharply in advanced and metastatic cases, underscoring the need for improved risk stratification. This article reviews the role of germline and somatic genetic alterations in prostate cancer development, prognosis, and treatment selection. It outlines current guideline-based indications for genetic testing, emerging evidence supporting broader testing strategies, and evolving tools including polygenic risk scores, tumor-derived genomic classifiers, digital histopathology platforms, and circulating tumor DNA.