Black men are less likely to choose investigation for symptoms that may herald prostate cancer, at all levels of risk, a UK study has found. A total of 555 men (286 black, 269 white), aged ≥ 40, were approached while awaiting a GP appointment and recruited to the study from four GP surgeries in Bristol. This study emphasises ethnic differences in attitudes towards prostate cancer diagnosis, and a different approach to risk. It is important therefore to be aware of these differences when discussing investigations with Afro-Caribbean men. Better targeting of PSA testing in higher risk black men is vital if we are to lessen the disparate burden this disease has on the Afro-Caribbean population.