Conclusions: Prostate cancer, including high-grade cancers, is not rare among patients with serum PSA levels ≤ 10 ng per milliliter; in group with serum PSA ≤ 10 ng per milliliter, Gleason scores and the percentage of samples of prostate adenocarcinoma in prostate needle biopsies is lower than those in group with serum PSA > 10 ng per milliliter.