Individual research recommendation details

Recommendation ID

NG131/6

Question

Staging investigations for CPG 3 prostate cancer: What is the diagnostic accuracy of staging investigations for CPG 3 prostate cancer?

Any explanatory notes
(if applicable)

Why the committee made the recommendation:
The 2019 guideline used a 3‑tier model for risk stratification. The committee agreed that newer evidence shows 5‑tier risk stratification models are better at predicting prostate cancer-specific mortality than 3‑tier models. More accurate prognosis will mean that more people are given the most effective treatment. The committee recommended the 5‑tier Cambridge Prognostic Group (CPG) model over other 5‑tier models because it has been tested in UK populations.

Impact on other recommendations:
The committee considered the impact of recommending the CPG risk stratification model on other recommendations in the guideline. Recommendations were amended as necessary, taking into account the original evidence for each recommendation and the committee's knowledge and experience.

How the recommendation might affect practice:
The committee were confident that recommending the 5‑tier CPG risk stratification model would not have a significant resource impact. This was because the same information is used to calculate both the CPG model and the previously recommended 3‑tier model. However, MDTs will need to be aware of the new 5‑tier model when assessing patient risk. Under the 5‑tier CPG risk stratification model more people would be in the lowest risk group (CPG 1) than were previously categorised as 'low risk'. The previous 'intermediate-risk' group now consists of some people in CPG 1, and all people in CPG 2 and CPG 3, and recommendations that were previously for people at 'intermediate risk' would now apply to a smaller group. CPG 4 and CPG 5 directly align to the previous 'high-risk' group, so the number of people in this category would not change. These changes are not expected to affect treatment choices in a way that would have a significant resource impact.

Full details of the evidence and the committee's discussion are in evidence review I: risk stratification for localised prostate cancer.

Source guidance details

Comes from guidance

Prostate cancer: diagnosis and management

Number

NG131

Date issued

May 2019

Other details