Contemporary evaluations of prostate cancer risk now typically include patient demographic factors, medical history, family history of prostate cancer, biomarkers, and imaging findings. Simple nomograms in tabular format are suboptimal in presenting risk for more than a few such factors; therefore, several groups have developed risk calculators based on actual patient data that allow patients and clinicians to simultaneously incorporate a larger number of these risk factors. It is beyond the scope of this Guideline to provide an exhaustive review of all published risk calculators, but several discussed by the Panel are listed below, noting that different risk calculators often use different risk factors.97, 98  One of the first risk calculators that was widely disseminated was based on the Prostate Cancer Prevention Trial (PCPT).99 A number of additional datasets and risk factors have since been incorporated.100 This risk calculator currently includes race, age, PSA, percent free PSA, family history of prostate cancer, DRE, prior biopsy, and urinary Prostate Cancer Antigen 3 [PCA3]. Chun is a comparable risk calculator that likewise includes age, PSA, DRE, prior biopsy, urinary PCA3, and prostate volume.101 When compared, both of these risk calculators could be applied to estimate the risk of prostate cancer while also reducing the need for a prostate biopsy, although PCPT had higher AUC (0.84).102 Several data driven risk calculators developed based on a clinical trial were developed in Europe.103 The ERSPC online tool has several applications ranging from a risk calculator for patients who are interested in screening but have not had a PSA, to a risk calculator that includes age, PSA, DRE, prior biopsy, and prostate volume.104 More recently, prostate MRI was added to this calculator. When DeNunzio et al. compared PCPT, ERSPC and the Chun risk calculators, they found that Chun outperformed the other 2 when the endpoint was high-grade prostate cancer, defined as GG > 3 (Gleason Score ≥ 4+3=7);105 however, they only utilized the PSA-only version of the ERSPC risk calculator. In 2018, the Prostate Biopsy Collaborative Group (PBCG) published their calculator based on age, PSA, DRE, Black race, first-degree family history of prostate cancer, and prior negative biopsy.106 <img src="images/Guidelines/Guideline%20Images/2026%20EDPC/2026%20EDPC-%20Table%204.png" alt="TABLE 4: Select Risk Calculators with Risk Factors and Risk Factors Evaluated " title="TABLE 4: Select Risk Calculators with Risk Factors and Risk Factors Evaluated " width="700" height="302" class="blockImg" /> *There is no publicly available online calculator for Chun Historically, clinicians have expressed concern that using risk calculators and nomograms are cumbersome and difficult to incorporate into practice; however, given the rise of Electronic Medical Records (EMR), and the use of computers in most clinical encounters, web-based risk calculators have become easily accessible for real-time clinical conversations. In the course of discussing prostate cancer risk, clinicians can easily enter pertinent risk information into their choice of risk calculator and produce estimates including likelihood of finding cancer, finding significant cancer, and often with graphics/icon arrays that aid in interpretation of individualized numerical risk data.  While these risk calculators provide estimates that facilitate clinician-patient discussion of detection risk, it should be kept in mind that these are population averages with potentially wide intervals in some subsets. Moreover, the data for a number of these, while extensive, may be based on historic screening and detection approaches (e.g., prior to widespread prostate MRI adoption). Furthermore, calibration of risk calculators may differ by subgroups. In one study, investigators compared PBCG with PCPT and concluded that PCPT performed better in minority groups.97 One may also wish to use a U.S.-based risk calculator if this more closely resembles their practice population. Thus, clinicians need to incorporate their experience in the final refinement of risk estimates rather than solely relying on any of these risk calculator estimates as certainty.