# Cambridge Prognostic Group (CPG 1 to 5)

Source: https://onco.cc/terms/cambridge-prognostic-group/  
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## TL;DR

The five-band risk score the NHS uses for prostate cancer that has not spread. It combines the grade group, the PSA and the T stage into one number from 1 to 5, and NICE writes its treatment advice in those numbers rather than in low, intermediate and high risk.

## Summary

NICE NG131 recommendation 1.2.15 asks urological cancer multidisciplinary teams to assign a risk category from its table 1 to everyone with newly diagnosed localised or locally advanced prostate cancer, and that table is the Cambridge Prognostic Groups. Group 1 is Gleason score 6 (grade group 1) and PSA under 10 micrograms per litre and stage T1 to T2. Group 2 is Gleason 3+4=7 (grade group 2) or PSA 10 to 20, with stage T1 to T2. Group 3 is Gleason 3+4=7 and PSA 10 to 20 and stage T1 to T2, or Gleason 4+3=7 (grade group 3) at stage T1 to T2. Group 4 is any one of Gleason 8 (grade group 4), PSA above 20, or stage T3. Group 5 is two or more of those three, or Gleason 9 to 10 (grade group 5), or stage T4.

The point of the five bands is that the old three-tier model, which NG131 carried until the 2021 amendment and which came from D'Amico, could not tell Gleason 3+4 from 4+3 and so put two quite different diseases in one intermediate box. The whole treatment section of NG131 is now written in CPG numbers: active surveillance is offered in CPG 1, offered as one of three equal choices in CPG 2, considered in CPG 3 for people who decline immediate radical treatment, and not offered in CPG 4 and 5 (recommendations 1.3.8 to 1.3.12); radiotherapy is combined with androgen deprivation from CPG 2 upwards, for six months, and considered for up to three years in CPG 4 and 5; isotope bone scans are not routinely offered in CPG 1 and 2. The American NCCN bands, which split intermediate risk into favourable and unfavourable and add a very high band, are a different system answering the same question, and the two do not map exactly onto each other. The Cambridge group also publishes PREDICT Prostate, a separate tool that adds the number of positive cores and the presence of intraductal or cribriform growth to produce an individual survival estimate rather than a band.

## Fields

- Kind: Term
- Last checked: 2026-09-25
- Also known as: CPG; CPG 1; CPG 2; CPG 3; CPG 4; CPG 5; Cambridge Prognostic Groups; Cambridge prognostic group; five-tier risk stratification; NICE risk stratification prostate

## Notes

- The Royal College of Pathologists dataset prints both tables side by side, the older three-tier NICE table and the Cambridge groups, and notes that the Cambridge model 'does differentiate between grade group 2 and grade group 3', which the three-tier model does not.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Prostate_cancer_staging
- NICE NG131: prostate cancer, diagnosis and management (recommendations, including the Cambridge Prognostic Group table at 1.2.15): https://www.nice.org.uk/guidance/ng131/chapter/Recommendations
- Royal College of Pathologists G084: dataset for histopathology reports for prostatic carcinoma, version 4, October 2024: https://www.rcpath.org/static/8cc88604-2c8d-4df4-a99542df41c102af/G084-dataset-for-histopathology-reports-for-prostatic-carcinoma.pdf
- NCCN Guidelines: prostate cancer (the American risk groups): https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459

## Connected records

- terms: [Active surveillance and observation](https://onco.cc/terms/active-surveillance-term/), [Disease-specific staging and risk systems (FIGO, Ann Arbor, IPI, R-ISS, ELN, IMDC)](https://onco.cc/terms/staging-systems/), [Extraprostatic extension and seminal vesicle invasion](https://onco.cc/terms/extraprostatic-extension/), [Gleason score / Grade Group](https://onco.cc/terms/gleason-grade-group/), [Percentage of Gleason pattern 4](https://onco.cc/terms/percentage-gleason-pattern-4/), [PSA (prostate-specific antigen)](https://onco.cc/terms/psa/), [PSA density](https://onco.cc/terms/psa-density/), [PSA kinetics: PSA doubling time and PSA density](https://onco.cc/terms/psa-kinetics/), [TNM staging](https://onco.cc/terms/tnm-staging/), [TNM staging for prostate cancer, and what changed in the 9th edition](https://onco.cc/terms/tnm-prostate-cancer/), [Watchful waiting, and how it differs from active surveillance](https://onco.cc/terms/watchful-waiting/)
- cancers: [Biochemical recurrence of prostate cancer](https://onco.cc/cancers/prostate-bcr/), [Ductal adenocarcinoma of the prostate](https://onco.cc/cancers/prostate-ductal-adenocarcinoma/), [Localised prostate cancer, high and very high risk](https://onco.cc/cancers/prostate-high-risk/), [Localised prostate cancer, intermediate risk](https://onco.cc/cancers/prostate-intermediate-risk/), [Localised prostate cancer, very low and low risk](https://onco.cc/cancers/prostate-low-risk/), [Metastatic hormone-sensitive prostate cancer](https://onco.cc/cancers/prostate-mhspc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- fronts: [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/)

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