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Approximately three dozen germline genetic markers have been consistently associated with prostate cancer (PCa) risk.In the past several years, we have developed a genetic panel of 33 PCa risk-associated SNPs and demonstrated that it can distinguish individuals risk to PCa in a large randomized clinical trial (the REDUCE trial).The genetic markers performed significantly better than established PCa markers including PSA and family history.Furthermore, we demonstrated the statistically significant added benefit of the genetic markers to the best clinical model consisting of five parameters.As a result, the risk categories of one third of the men were reclassified by adding genetic markers to the best clinical model.Regarding the utility of genetic score in identifying men who benefit most from the chemoprevention, we found that men at highest genetic score and have a positive family history had highest PCa reduction rate.Furthermore, in contrast to the previous reports that chemoprevention increased the risk to high-grade PCa, we observed that it reduced the risk to high-grade PCa in men with highest genetic score and positive family history.These results suggest that genetic markers may be used to improve the performance of existing clinical parameters in determining the need for prostate biopsy and chemoprevention.Similar findings were observed in Chinese men.