Genetic testing has increasingly been incorporated into clinical practice to identify patients in need of additional screening, stratify risk among patients with cancer, and allow doctors to intervene sooner in potentially high-risk tumors. While already a mainstay in the risk stratification for several cancer types, such as enhanced breast cancer screening for people with BRCA1 or BRCA2 pathogenic variants and colon cancer screening for people with Lynch Syndrome, genetic testing is currently being considered for new cancers, such as prostate cancer. Bancroft et al. recently demonstrated that patients who have been identified with germline mismatch repair pathogenic variants in MLH1, MSH2, or MSH6 genes may benefit from targeted PSA screening to identify clinically significant prostate cancer.1 Despite the numerous advantages in genetic testing, we contextualize this technology in a disparities framework, highlighting the persisting equity challenges that remain, and potential steps forward.