Macneil J, et al. - A retrospective cohort study was carried out on prostatectomy specimens from the prostate cancer database of a single large Australian pathology practice which services a large proportion of hospitals within one state (n = 11,551) in order to ascertain whether variations existed in the pathological features of prostate cancer occurring in younger men as in comparison with the disease when it happens in elderly males. In a number of pathological features, statistically important variations were seen. Lower grade group disease was seen in younger males along with less adverse pathological features within it. Especially, a lower risk of extra prostatic extension, and lymph node involvement, with trends toward superiority in other domains was noted in Grade Group 2 disease even subsequent to controlling for confounding in men 45 and younger. Hence, the results exhibit that compared with elderly men prostate cancer in younger men is of lower grade and stage disease. Moreover, this is in comparison with consistent views within the urological community and could have an influence on disease management in younger men.