OBJECTIVES: The Cancer Cell Progression (CCP ) score is a validated  genomic  assay that assesses risk of prostate cancer−specific disease progression and mortality when combined with standard clinic-pathologic parameters to identify patients at low / very low risk of progression who are candidates  for treatment abstention and surveillance. This study assesses the cost-effectiveness of the use of the CCP score versus actual risk-stratification practice in France in making treatment decisions for men diagnosed with low risk prostate cancer.  METHODS: A Markov model was designed comparing treatment decisions based on diagnosis with and without the CCP score in men with localised low risk cancer prostate. Short term benefits were the number of radical treatments avoided at diagnosis. Expected long term benefits were avoiding delayed curative treatments for patients misdiagnosed as low risk, according to standard criteria. Direct medical costs were considered and were identified through public data sources. Transition probabilities, mortality rates and utilities were derived from a literature review. Costs and benefits were discounted at a 4% rate.  RESULTS: The use of the CCP score at the time of diagnosis led to a 41 % reduction of the number of initial ablative treatments.  The test generated an extra cost varying between € 12 and € 644,   according to different price assumptions.  In the long term, at a hypothetical price of € 2,000, using the test was a dominant strategy, with lower lifetime discounted costs of € 1,709 and an incremental discounted QALY gain of 0.23.  CONCLUSIONS: The information provided by the test has the potential to reduce the number of unnecessary invasive treatments for low risk patients. Overall, the use of CCP score leads to cost savings and an improved quality of life by avoiding the side effects of more radical therapy.