Despite overall declines in rates of aggressive prostate cancer (PCa) in the U.S., racial disparity persists, with African American (AA) men experiencing rates greater than 2X those for European American (EA) men. While prostate specific antigen (PSA) screening has made a major contribution to the mortality decline, new screening strategies are needed to identify potentially lethal cancer while limiting risks. The overall goal of this project is to obtain reliable age-adjusted estimates of the distribution of Prostate Health Index (PHI) in healthy AA men, and compare this distribution to the PHI distribution of AA men with negative prostate biopsies and men with indolent and non-indolent PCa. This will provide evidence for the potential of the PHI score to be used as a PCa screening test to replace PSA. Our hypothesis is that PHI will have different distributions in AA men with benign prostatic disease, malignant prostatic disease and healthy controls. We propose to recruit a cohort of 100 healthy control AA men age 30-69y/o without prostate cancer to establish normal age-adjusted ranges for PHI and compare distributions of PHI scores and their components in AA healthy controls, in AA men with negative prostate biopsies and in AA men with PCa.