The Movember Foundation's GAP3 cohort: a profile of the largest global prostate cancer active surveillance database to date

Research output: Contribution to journalArticle


OBJECTIVES: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low-risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow-up for AS in this unique global AS database.

PATIENTS AND METHODS: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK and Europe). Data on a total of 15 101 patients were included. Descriptive statistics were used to report patients' clinical and demographic characteristics at the time of PCa diagnosis, clinical follow-up, discontinuation of AS and subsequent treatment. Cumulative incidence curves were used to report discontinuation rates over time.

RESULTS: At diagnosis, the median (interquartile range [IQR]) patient age was 65 (60-70) years and the median prostate-specific antigen level was 5.4 (4.0-7.3) ng/mL. Most patients had clinical stage T1 disease (71.8%), a biopsy Gleason score of 6 (88.8%) and one tumour-positive biopsy core (60.3%). Patients on AS had a median follow-up time of 2.2 (1.0-5.0) years. After 5, 10 and 15 years of follow-up, respectively, 58%, 39% and 23% of patients were still on AS. The current version of GAP3 has limited data on magnetic resonance imaging (MRI), quality of life and genomic testing.

CONCLUSIONS: GAP3 is the largest worldwide collaboration integrating patient data from men with PCa on AS. The results will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment. Longer follow-up and the evaluation of MRI, new genomic markers and patient-related outcomes will result in even more valuable data and eventually in better patient outcomes.


  • Sophie M Bruinsma
  • Liying Zhang
  • Monique J Roobol
  • Chris H Bangma
  • Ewout W Steyerberg
  • Daan Nieboer
  • Mieke Van Hemelrijck
  • Anders Bjartell (Contributor)
  • Movember Foundation's Global Action Plan Prostate Cancer Active Surveillance (GAP3) consortium
External organisations
  • Skåne University Hospital
  • Erasmus University Medical Center
  • University of Toronto
  • King's College London
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology


  • Aged, Aged, 80 and over, Charities/organization & administration, Cohort Studies, Databases, Factual, Disease Progression, Early Detection of Cancer, Global Health, Humans, Male, Men's Health, Middle Aged, Prognosis, Prostatic Neoplasms/epidemiology, Public Health Surveillance, Risk Assessment, Time Factors, Time-to-Treatment, Watchful Waiting
Original languageEnglish
Pages (from-to)737-744
JournalBJU International
Issue number5
Publication statusPublished - 2018 May
Publication categoryResearch

Bibliographic note

© 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.