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These days it's becoming Betteridge's second law that "could" means "won't"...
I don’t even want to hear about possibilities anymore. I just want things made public when it’s here already or available for use right now.
to be fair, 'could' implies a lower chance than 'should' and 'would'
... and lead to a massive increase in iatrogenic deaths, and deaths from diversion of scarce medical resources from more important diseases.

Sounds like a net negative, even if restricted to males from 20-44.

Anything can sound like a net negative if you literally make up a negative statement about it.
The article mentions over-treatment, and I haven't looked into statistics for over-diagnosis of prostate cancer, but for two members in my family, their doctors preferred the wait-and-see method which lead to untreatable cancer in one case and a near-miss delayed treatment in another. I’d rather be alive, but these doctors appeared more focused on the side effects of prostate removal on sex and incontinence. Any improved method of detecting when dangerous cancer in the prostate needs to be removed would help to clear up priorities for both doctor’s and patients.
Theres been controversy over the use of PSA levels for at least a decade which is perhaps why this fMRI is being pushed, however fMRI is much less invasive than biopsy needles inserted into the prostrate.

Still havent seen any mention of zinc being useful for the prostrate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7424038/ "Zinc Deficiency in Men Over 50 and Its Implications in Prostate Disorders"