Multi-Cancer Early Detection (MCED) offers a different approach. Using a blood sample, these tests look for biological signals that may indicate the presence of cancer and can analyse multiple cancer types simultaneously. Some technologies can also indicate where in the body the cancer signal is likely to originate, helping to guide further diagnostic investigations.

MCED could complement existing screening programmes and extend opportunities for earlier detection to cancers that currently lack established screening methods. In the longer term, the technology could become part of a more integrated diagnostic system in which blood-based tests, existing screening programmes, medical imaging and more targeted diagnostic tests complement one another.

From promising technology to clinical application

The field has now reached a stage where progress is being made on several fronts simultaneously. Large clinical studies are under way, regulatory authorities are evaluating the evidence, and some tests have begun to enter the commercial market.

One recent example is Galleri, an MCED test developed by US diagnostics company GRAIL. The test has been evaluated in NHS-Galleri, a randomised trial involving more than 142,000 participants in England. The study was conducted by the Cancer Research UK Cancer Prevention Trials Unit at Queen Mary University of London, in partnership with NHS England, with GRAIL as the principal funder.

The study did not meet its primary endpoint of demonstrating a statistically significant reduction in stage III and IV cancer diagnoses across the 12 predefined cancer types. However, the incidence of stage IV cancer was numerically lower in the group offered the test. The findings illustrate an important challenge for the next phase of development: beyond identifying cancer signals, these tests need to demonstrate that they contribute to earlier diagnosis in ways that also improve patient outcomes.

What is needed for the next stage?

Several factors need to be addressed before MCED can achieve broader clinical adoption. One central question is clinical benefit – whether screening actually leads to fewer late-stage diagnoses and, in the longer term, can contribute to lower cancer mortality. At the same time, the tests must be sufficiently accurate to detect cancer while minimising incorrect results.

False-positive results can lead to additional investigations in people who do not have cancer, while false-negative results may create a false sense of reassurance. There is also a risk of overdiagnosis, where screening detects cancers that would never have caused symptoms or affected a patient’s life expectancy.

Equally important is what happens after the blood test itself. A positive result must be followed by clear and effective diagnostic pathways, and MCED needs to be integrated with existing screening programmes and healthcare processes.

The US National Cancer Institute (NCI) is currently conducting the Vanguard Study, involving up to 24,000 participants and including MCED tests from Guardant Health and ClearNote Health. Among other objectives, the study will examine how testing and diagnostic follow-up work in practice and provide evidence to inform the design of a much larger randomised trial.

A rapidly developing field

Clinical progress is taking place alongside significant commercial activity. During 2026, Samsung invested USD 110 million in GRAIL, while Freenome raised more than USD 300 million through its stock market listing to support continued development in blood-based cancer diagnostics.

Larger diagnostics companies are also strengthening their positions. Abbott has acquired Exact Sciences, a leading cancer diagnostics company whose portfolio includes an MCED test, in a transaction valuing the company at approximately USD 21 billion. Meanwhile, Guardant Health has begun introducing its MCED test, Shield, in several Asian markets.

This activity reflects both the considerable potential and the breadth of the field. Developments also suggest that different diagnostic methods may increasingly complement one another and serve different purposes throughout the patient care pathway. If MCED can complement existing screening programmes and help detect more cancers at a treatable stage, the technology could become an important part of the future of cancer diagnostics.