UCSF-CAPRA Score for Prostate Cancer Risk

This tool should support, not replace, clinical judgment and shared decision-making; do not use results as the sole determinant of treatment.

The following are based on guidelines from the American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and Society of Urologic Oncology (SUO) (also endorsed by the American Society of Clinical Oncology [ASCO]):

• Very low-risk disease: Active surveillance is the best available option.
• Low-risk disease: 
  
  • Active surveillance is the preferred option for most patients.
  • Select low-risk patients at high probability of progressing on active surveillance may instead be offered definitive treatment (radical prostatectomy or radiotherapy).
• Intermediate-risk disease: Treatment options depend on shared decision-making between the patient and clinician and on whether the disease is determined to be favorable or unfavorable after further evaluation. 
  
  • For unfavorable disease: Radical prostatectomy or radiotherapy combined with androgen-deprivation therapy are the standard treatment options.
  • For favorable disease: 
    
    • Radiation alone is an option, although the supporting evidence is less robust than for radiation combined with androgen-deprivation therapy. 
    • Active surveillance may be offered to select patients with counseling that this carries a higher risk of eventual metastasis than definitive treatment.
• High-risk disease: Radical prostatectomy or radiotherapy combined with androgen-deprivation therapy are the standard treatment options.