---
title: "Multicancer Early-Detection Blood Test and Impact on Late-Stage Cancer Diagnosis"
id: "pubmed-42776074"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42776074"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42776074/"
doi: "10.1056/NEJMoa2505723"
published_at: "2026-10-08T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Multicancer Early-Detection Blood Test and Impact on Late-Stage Cancer Diagnosis
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42776074
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42776074/)
- **DOI:** [10.1056/NEJMoa2505723](https://doi.org/10.1056%2FNEJMoa2505723)
- **Published At:** 2026-10-08T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Randomized, controlled multicenter trial in England evaluated whether adding a **multicancer early-detection** blood test to usual care reduces late-stage cancer diagnoses. - Participants: community-dwelling adults aged 50 to 77; blood samples obtained at up to three annual visits; randomization 1:1 after baseline collection to intervention (blood tested) or control (blood stored). - Blinding: participants and trial personnel were initially unaware of group assignments. - Primary end point: incidence rate of **stage III or IV cancer** across 12 prespecified cancer types after three screening rounds and at least 12 months' follow-up after the last third visit. - Key secondary end point: incidence rate of **stage IV cancer** among the same 12 prespecified cancers. - Enrollment and allocation: 71,122 participants randomized to the intervention group and 71,128 to the control group. - Primary outcome: no significant difference in the incidence rate of stage III or IV cancer between groups (incidence rate ratio 1.03; 95% CI, 0.92 to 1.14; P = 0.63). - Secondary outcome: the incidence rate ratio for stage IV cancer after three screening rounds was 0.86 (95% CI, 0.74 to 1.00), indicating a possible reduction that warrants further follow-up. - Safety: trial-related adverse events occurred in fewer than 1% of participants; none were serious. - Conclusion: After three screening rounds, multicancer early-detection testing plus usual care did not lower the incidence rate of stage III or IV cancers across the prespecified cancers compared with usual care alone; additional follow-up is needed to evaluate evolving effects, particularly for stage IV cancers. - Trial identifiers and funding: Funded by Grail; trial registered as NHS-Galleri ClinicalTrials.gov NCT05611632 and ISRCTN91431511.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 22. # Effect of Screening with Multicancer Early-Detection Test on Late-Stage Cancer Diagnosis [Peter Sasieni](https://pubmed.ncbi.nlm.nih.gov/?term=Sasieni+P&cauthor_id=42776074)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-1 "Queen Mary University of London, London."), [Peter Johnson](https://pubmed.ncbi.nlm.nih.gov/?term=Johnson+P&cauthor_id=42776074)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-2 "NHS England, London."), [Thomas Round](https://pubmed.ncbi.nlm.nih.gov/?term=Round+T&cauthor_id=42776074)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-3 "King's College London, London."), [Jane Warwick](https://pubmed.ncbi.nlm.nih.gov/?term=Warwick+J&cauthor_id=42776074)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-1 "Queen Mary University of London, London."), [Helen Jones](https://pubmed.ncbi.nlm.nih.gov/?term=Jones+H&cauthor_id=42776074)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-4 "EMS Healthcare, Cheshire, United Kingdom."), [Saoirse Dolly](https://pubmed.ncbi.nlm.nih.gov/?term=Dolly+S&cauthor_id=42776074)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-5 "Guy's and St. Thomas' NHS Foundation Trust, London."), [Lennard Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+L&cauthor_id=42776074)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-6 "University of Oxford, Oxford, United Kingdom."), [Yujin Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+Y&cauthor_id=42776074)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-1 "Queen Mary University of London, London."), [Harpal Kumar](https://pubmed.ncbi.nlm.nih.gov/?term=Kumar+H&cauthor_id=42776074)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-7 "GRAIL Bio UK, London."), [Wei Liang](https://pubmed.ncbi.nlm.nih.gov/?term=Liang+W&cauthor_id=42776074)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-7 "GRAIL Bio UK, London."), [Rebecca Smittenaar](https://pubmed.ncbi.nlm.nih.gov/?term=Smittenaar+R&cauthor_id=42776074)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-7 "GRAIL Bio UK, London."), [Richard D Neal](https://pubmed.ncbi.nlm.nih.gov/?term=Neal+RD&cauthor_id=42776074)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-8 "University of Exeter, Exeter, United Kingdom."), [Charles Swanton](https://pubmed.ncbi.nlm.nih.gov/?term=Swanton+C&cauthor_id=42776074)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-9 "University College London, London.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#full-view-affiliation-10 "Francis Crick Institute, London.") Affiliations Expand ### Affiliations * 1 Queen Mary University of London, London. * 2 NHS England, London. * 3 King's College London, London. * 4 EMS Healthcare, Cheshire, United Kingdom. * 5 Guy's and St. Thomas' NHS Foundation Trust, London. * 6 University of Oxford, Oxford, United Kingdom. * 7 GRAIL Bio UK, London. * 8 University of Exeter, Exeter, United Kingdom. * 9 University College London, London. * 10 Francis Crick Institute, London. * PMID: **42776074** * DOI: [ 10.1056/NEJMoa2505723 ](https://doi.org/10.1056/nejmoa2505723) Item in Clipboard Randomized Controlled Trial # Effect of Screening with Multicancer Early-Detection Test on Late-Stage Cancer Diagnosis Peter Sasieni et al. N Engl J Med. 2026. Show details Display options Display options Format Abstract PubMed PMID N Engl J Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22N+Engl+J+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22N+Engl+J+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42776074/) . 2026 Oct 8;395(14):1374-1386. doi: 10.1056/NEJMoa2505723. Epub 2026 Sep 22. ### Authors [Peter Sasieni](https://pubmed.ncbi.nlm.nih.gov/?term=Sasieni+P&cauthor_id=42776074)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-1 "Queen Mary University of London, London."), [Peter Johnson](https://pubmed.ncbi.nlm.nih.gov/?term=Johnson+P&cauthor_id=42776074)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-2 "NHS England, London."), [Thomas Round](https://pubmed.ncbi.nlm.nih.gov/?term=Round+T&cauthor_id=42776074)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-3 "King's College London, London."), [Jane Warwick](https://pubmed.ncbi.nlm.nih.gov/?term=Warwick+J&cauthor_id=42776074)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-1 "Queen Mary University of London, London."), [Helen Jones](https://pubmed.ncbi.nlm.nih.gov/?term=Jones+H&cauthor_id=42776074)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-4 "EMS Healthcare, Cheshire, United Kingdom."), [Saoirse Dolly](https://pubmed.ncbi.nlm.nih.gov/?term=Dolly+S&cauthor_id=42776074)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-5 "Guy's and St. Thomas' NHS Foundation Trust, London."), [Lennard Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+L&cauthor_id=42776074)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-6 "University of Oxford, Oxford, United Kingdom."), [Yujin Lee](https://pubmed.ncbi.nlm.nih.gov/?term=Lee+Y&cauthor_id=42776074)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-1 "Queen Mary University of London, London."), [Harpal Kumar](https://pubmed.ncbi.nlm.nih.gov/?term=Kumar+H&cauthor_id=42776074)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-7 "GRAIL Bio UK, London."), [Wei Liang](https://pubmed.ncbi.nlm.nih.gov/?term=Liang+W&cauthor_id=42776074)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-7 "GRAIL Bio UK, London."), [Rebecca Smittenaar](https://pubmed.ncbi.nlm.nih.gov/?term=Smittenaar+R&cauthor_id=42776074)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-7 "GRAIL Bio UK, London."), [Richard D Neal](https://pubmed.ncbi.nlm.nih.gov/?term=Neal+RD&cauthor_id=42776074)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-8 "University of Exeter, Exeter, United Kingdom."), [Charles Swanton](https://pubmed.ncbi.nlm.nih.gov/?term=Swanton+C&cauthor_id=42776074)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-9 "University College London, London.")[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42776074/#short-view-affiliation-10 "Francis Crick Institute, London.") ### Affiliations * 1 Queen Mary University of London, London. * 2 NHS England, London. * 3 King's College London, London. * 4 EMS Healthcare, Cheshire, United Kingdom. * 5 Guy's and St. Thomas' NHS Foundation Trust, London. * 6 University of Oxford, Oxford, United Kingdom. * 7 GRAIL Bio UK, London. * 8 University of Exeter, Exeter, United Kingdom. * 9 University College London, London. * 10 Francis Crick Institute, London. * PMID: **42776074** * DOI: [ 10.1056/NEJMoa2505723 ](https://doi.org/10.1056/nejmoa2505723) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Background:** Whether screening with blood-based early-detection tests for multiple cancers in addition to usual care has clinical utility is unknown. **Methods:** In a randomized, controlled trial conducted in England, we obtained peripheral blood from persons 50 to 77 years of age at up to three annual visits. After baseline blood collection, participants were randomly assigned in a 1:1 ratio to the intervention group (participants whose blood was tested) or the control group (participants whose blood was stored). Participants and trial personnel were initially unaware of the group assignments. The primary end point was stage III or IV cancer among 12 prespecified types of cancer, and a key secondary end point was stage IV cancer among the 12 prespecified types. The differences between the groups in the incidence rate (the number of first eligible events divided by person-years at risk) were measured after three screening rounds and at least 12 months of follow-up after the last participant's third visit. **Results:** Overall, 71,122 participants were randomly assigned to the intervention group and 71,128 to the control group. The incidence rate of stage III or IV cancer (primary end point) did not differ significantly between the groups (incidence rate ratio [intervention vs. control], 1.03; 95% confidence interval [CI], 0.92 to 1.14, P = 0.63). The incidence rate ratio for stage IV cancer (a key secondary end point) after 3 screening rounds was 0.86 (95% CI, 0.74 to 1.00). Less than 1% of participants had trial-related adverse events; none were serious. **Conclusions:** In this trial, we did not observe a lower incidence rate of stage III or IV cancers across 12 prespecified cancers after three screening rounds with multicancer early-detection testing plus usual care than with usual care alone. Further follow-up is warranted to assess the way in which findings for stage III or IV cancers and the between-group difference in stage IV cancers evolve over time. (Funded by Grail; NHS-Galleri ClinicalTrials.gov number, [NCT05611632](http://clinicaltrials.gov/show/NCT05611632 "See in ClinicalTrials.gov"); ISRCTN number, ISRCTN91431511.). Copyright © 2026 Massachusetts Medical Society. 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