Following a prostate biopsy, clinicians should not only share biopsy results with patients but also make recommendations for further follow-up. Routine management after a negative biopsy would be resumption of screening. The time frame for next evaluation should mirror the standard screening interval, such that a patient should be re-evaluated within two to four years or sooner, typically with a PSA (see Statement 6). While negative prostate biopsy significantly lowers the probability of subsequently identifying GG2+ prostate cancer, the protective effect of a negative biopsy likely subsides over time since prior biopsy. Patients with a prior negative biopsy remain at risk for undetected or subsequent development of GG2+ disease. The systematic review performed for this Guideline, has shown that 5% to 25% of patients who undergo a subsequent biopsy in the short term are diagnosed with GG2+ disease.238-246 Additionally, over a 20-year time horizon, the risk of prostate cancer mortality ranges from 1.4% to 5.2%.247, 248 Therefore, a negative biopsy alone should not be used to justify discontinuation of prostate cancer screening. PSA level alone should not be used to decide whether to repeat the prostate biopsy in patients with a previous negative biopsy.106 While PSA does factor into risk calculation, it should not be used exclusively to justify repeat biopsy, especially if the original biopsy was prompted by an elevated PSA, because this can result in repeated unnecessary biopsies. If concern remains elevated for GG2+ based on PSA density, previous MRI findings, or other factors, the clinician and patient may consider adjunctive testing (blood, urine, or tissue tests), or MRI (if not previously performed) to further risk stratify the patient and guide further management. The likelihood of identifying GG2+ disease on subsequent biopsy has been associated with a few factors, including age, Black race, total PSA, percent free PSA,107 PSA density,249 abnormal DRE findings, presence of germline mutations, pathology findings on prior biopsy (e.g., AIP), results of available adjunctive testing, number of cores taken at initial biopsy, MRI findings, planned method of subsequent biopsy (e.g., number of cores, saturation, template mapping),238-246 and family history.106 Previous biopsy reduces the risk of identifying GG2+ disease on subsequent biopsy and should be considered in decisions about further management.106 Given the multiple factors involved in computing the risk of GG2+ disease, the Panel recommends use of a risk calculator (see Statement 10) that incorporates standard factors, with or without additional factors.106, 107, 249, 250 (see Table 4) For example, in a patient with a low risk of GG2+ disease based on risk calculation, the clinician and patient may decide to discontinue further prostate cancer screening (see Statement 7). Although, in a standard/high-risk patient, the clinician and patient may resume interval screening with or without adjunctive testing and/or repeat biopsy. As in the PSA screening setting, the use of SDM is highly recommended given the uncertainty involved.