{"entity":{"id":"cambridge-prognostic-group","kind":"term","name":"Cambridge Prognostic Group (CPG 1 to 5)","aka":["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"],"tldr":"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.\n\nThe 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.","asOf":"2026-09-25","wikipedia":"https://en.wikipedia.org/wiki/Prostate_cancer_staging","links":[{"label":"NICE NG131: prostate cancer, diagnosis and management (recommendations, including the Cambridge Prognostic Group table at 1.2.15)","url":"https://www.nice.org.uk/guidance/ng131/chapter/Recommendations"},{"label":"Royal College of Pathologists G084: dataset for histopathology reports for prostatic carcinoma, version 4, October 2024","url":"https://www.rcpath.org/static/8cc88604-2c8d-4df4-a99542df41c102af/G084-dataset-for-histopathology-reports-for-prostatic-carcinoma.pdf"},{"label":"NCCN Guidelines: prostate cancer (the American risk groups)","url":"https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459"}],"tags":[],"related":["gleason-grade-group","psa","active-surveillance-term","staging-systems","tnm-staging"],"cancers":["prostate","prostate-low-risk","prostate-intermediate-risk","prostate-high-risk"],"sections":["diagnostics"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["gleason-grade-group","psa","tnm-prostate-cancer","percentage-gleason-pattern-4"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"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."],"category":"Clinical"},"route":"/terms/cambridge-prognostic-group/","neighbours":{"term":[{"id":"active-surveillance-term","kind":"term","name":"Active surveillance and observation","route":"/terms/active-surveillance-term/"},{"id":"staging-systems","kind":"term","name":"Disease-specific staging and risk systems (FIGO, Ann Arbor, IPI, R-ISS, ELN, IMDC)","route":"/terms/staging-systems/"},{"id":"extraprostatic-extension","kind":"term","name":"Extraprostatic extension and seminal vesicle invasion","route":"/terms/extraprostatic-extension/"},{"id":"gleason-grade-group","kind":"term","name":"Gleason score / Grade Group","route":"/terms/gleason-grade-group/"},{"id":"percentage-gleason-pattern-4","kind":"term","name":"Percentage of Gleason pattern 4","route":"/terms/percentage-gleason-pattern-4/"},{"id":"psa","kind":"term","name":"PSA (prostate-specific antigen)","route":"/terms/psa/"},{"id":"psa-density","kind":"term","name":"PSA density","route":"/terms/psa-density/"},{"id":"psa-kinetics","kind":"term","name":"PSA kinetics: PSA doubling time and PSA density","route":"/terms/psa-kinetics/"},{"id":"tnm-staging","kind":"term","name":"TNM staging","route":"/terms/tnm-staging/"},{"id":"tnm-prostate-cancer","kind":"term","name":"TNM staging for prostate cancer, and what changed in the 9th edition","route":"/terms/tnm-prostate-cancer/"},{"id":"watchful-waiting","kind":"term","name":"Watchful waiting, and how it differs from active surveillance","route":"/terms/watchful-waiting/"}],"cancer":[{"id":"prostate-bcr","kind":"cancer","name":"Biochemical recurrence of prostate cancer","route":"/cancers/prostate-bcr/"},{"id":"prostate-ductal-adenocarcinoma","kind":"cancer","name":"Ductal adenocarcinoma of the prostate","route":"/cancers/prostate-ductal-adenocarcinoma/"},{"id":"prostate-high-risk","kind":"cancer","name":"Localised prostate cancer, high and very high risk","route":"/cancers/prostate-high-risk/"},{"id":"prostate-intermediate-risk","kind":"cancer","name":"Localised prostate cancer, intermediate risk","route":"/cancers/prostate-intermediate-risk/"},{"id":"prostate-low-risk","kind":"cancer","name":"Localised prostate cancer, very low and low risk","route":"/cancers/prostate-low-risk/"},{"id":"prostate-mhspc","kind":"cancer","name":"Metastatic hormone-sensitive prostate cancer","route":"/cancers/prostate-mhspc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"diagnostics","kind":"section","name":"Diagnostics & Biomarkers","route":"/fronts/diagnostics/"}]}}