Eugene Shenderov, MD, PhD, Johns Hopkins Medicine, Baltimore, MD, discusses the current state of the detection and risk stratification of localized prostate cancer. Early diagnosis is crucial for identifying which patients need aggressive treatment and which patients can live with the disease. Dr Shenderov highlights the great strides made in prostate-specific antigen (PSA) detection and recommends that more work needs to be done in figuring out which diagnostic tests (including genomic risk stratification and imaging-based modalities) are best, as well as ensuring that patients have access to the necessary healthcare and testing. This interview took place at the European Society for Medical Oncology (ESMO) 2021 congress.