There’s a difference between genetic (germline) testing and biomarker (genomic) testing.
> Biomarker (genomic) testing looks for genes, proteins, and tumor markers that tell
more about the prostate cancer (for instance, what may have been acquired - mutated variants - caused by cell mutations or environmental factors).

> Genetics (germline) testing looks for genes (i.e., “germlines”) that have been inherited from parents. (e.g., BRCA1/2,
ATM, CHEK2, HOXB13, MSH2, etc.).

Which do those insurance companies look at - genetic, biomarker, or both?

There are other legitimate resources out there (like PCRI) that have information on all of these topics. PCF is just one of many available resources.

I never had a Decipher test; I had both the Prolaris test and the OncotypeDx test; both told me what I needed to know.

For me, I wanted to know any possible genetic component (and deal with whatever might happen later later). This organization gives free genetic (germline) testing: https://www.prostatecancerpromise.org/

I had none of the gene mutations they tested for (even though I was diagnosed with prostate cancer in 2012; my oldest brother had none of the gene mutations a different company tested for (even though he was diagnosed with prostate cancer earlier this year). My older brother probably had prostate cancer (suspected due to an elevated PSA); but he never pursued additional testing since he was dying of pancreatic cancer at the time.

They estimate that only about 15% of prostate cancers have a genetic component, so the odds are that you don’t. But if you do, that increases by 50% the chance of a 1st-degree relative having prostate cancers. (Also remember that prostate cancer and breast cancer share some of the same gene mutations. So, either parent can pass that gene mutation to sons or daughters.)

The recommendations for baseline PSA testing have remained relatively unchanged for over 30 years. (I started annual PSA testing at 45y.) Here’s an article from 1992 discussing this topic.