Several risk factors for prostate cancer death are well defined. These include age, race (African American), and a family history of prostate cancer. Data also suggest that a family history of breast cancer may provide an additional risk factor for prostate cancer. Despite the fact that these risk factors are well recognized, there are no reports describing a systematic early detection program for prostate cancer in African-American men with an increased familial risk of the disease. In this report, 169 such men between the ages of 40 and 70 are identified. Ninety-five of these men received a prostate-specific antigen and digital rectal examination. The mean age for these 95 men was 52 +/- 8 years; 45.3% were less than age 50. Eighty of these men had a family history of prostate cancer; 15 had a family history of breast cancer. Seventeen men had an abnormal screening test, and 14 subsequently had a prostate biopsy. Four prostate cancers were identified, all within the group of men reporting a positive family history of prostate cancer. In addition to describing the medical aspects of this series, a detailed description of recruiting efforts is also described.