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Article History

Received: 4 September 2024

Revised: 5 April 2025

Accepted: 3 June 2025

First Online: 2 July 2025

Competing interests

: Professor Rosalind Eeles has the following conflicts of interest to declare: Honoraria from GU-ASCO, Janssen, University of Chicago, Dana Farber Cancer Institute USA as a speaker. Educational honorarium from Bayer and Ipsen, member of external expert committee to Astra Zeneca UK and Member of Active Surveillance Movember Committee. She is a member of the SAB of Our Future Health. She undertakes private practice as a sole trader at The Royal Marsden NHS Foundation Trust and 90 Sloane Street SW1X 9PQ and 280 Kings Road SW3 4NX, London, UK. The remaining authors declare no competing interest.

: The IMPACT study protocol was reviewed and approved by the West-Midlands Research and Ethics Committee in the UK (reference: 05/MRE07/25) and subsequently by each participating institution’s local committee. All participants provided written consent, and the study was performed in accordance with the Declaration of Helsinki. The clinical studies are coordinated by the Institute of Cancer Research, London, UK. This project represents independent research supported by The National Institute for Health Research (NIHR) Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.