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A single blood (or urine) test meant to look for many cancers at once, including ones with no screening today. About 27 such tests are sold or in study worldwide; none has yet been shown in a randomised trial to reduce cancer deaths, and the one randomised result so far did not reduce late-stage diagnoses.
What exists. OnCo's census of 29 October 2026 found 27 multi-cancer tests that are sold, in clinical validation or published, in the United States, Europe and Asia, reading cell-free DNA methylation (Galleri, Shield MCD, Avantect, OverC, PanSeer, CancerFind), DNA fragment patterns (SPOT-MAS, SeekInCare, ai-CANCERCH), proteins (OneTest, OncoSeek, Novelna), methylation with proteins (Cancerguard), sugar molecules in urine and blood (Elypta), circulating tumour cells (Trucheck), platelet RNA (thromboSeq), infrared spectra (Dxcover), nucleosomes (Nu.Q), amino acids (AminoIndex) and even worms' sense of smell (N-NOSE). The tests sold to the public are laboratory-developed tests or CE- or UKCA-marked products; no multi-cancer screening test had been approved by the FDA, China's NMPA or Japan's PMDA by 29 October 2026, and a CE mark is a conformity mark, not evidence that screening helps. GRAIL's Galleri is furthest: a premarket approval application filed on 29 January 2026 and an FDA advisory panel vote of seven to two in favour on 23 September 2026, with no FDA decision yet. Several others hold FDA Breakthrough Device designations (Shield MCD, OverC, SPOT-MAS 10), which speed review but are not approvals. US Medicare coverage of FDA-authorised multi-cancer tests begins on 1 January 2029 under Public Law 119-75.
What the evidence shows. Almost all published performance comes from case-control studies of people already diagnosed, which overstate how a test performs in screening. Where tests have been run prospectively in people without symptoms, about one in a hundred to two hundred tests is positive and 40 to 60 in 100 positives are cancer (PATHFINDER 2: 60.3%; NHS-Galleri: 45.8 to 58.0%; K-DETEK with SPOT-MAS: 39.5%), and Galleri found about a quarter to two fifths of the cancers diagnosed within a year (26.7 to 37.2% per round in NHS-Galleri, 39.3% in PATHFINDER 2). Sensitivity for stage I cancer, where finding cancer early matters most, is about one in six for Galleri (16.8% in CCGA) and Cancerguard's development classifier (15.4%).
What it has not shown. The first randomised result is in: NHS-Galleri, 142,250 people in England, found no reduction in stage III or IV cancers after three yearly rounds (incidence rate ratio 1.03; 95% CI 0.92 to 1.14; Sasieni, NEJM 2026), with a secondary stage IV ratio of 0.86 (0.74 to 1.00). No multi-cancer test has been shown in a randomised trial to reduce cancer deaths. The NCI's randomised Vanguard study (Shield MCD and Avantect against usual care, 24,000 people) is testing how a definitive trial could be run. Until then a negative result does not replace bowel, breast, cervical or lung screening, and a positive result is the start of tests, not a diagnosis.
Machine learning classifies cell-free DNA methylation, fragmentation, mutations, proteins or other blood and urine signals, usually with a predicted organ of origin.
Nothing in the corpus depends on this yet.
Dependencies are what this technology cannot be delivered without: manufacturing steps, instruments, software, upstream methods. See its full chain on the map.
Adela's blood test in development for 20 cancer types, built on reading DNA methylation across the whole genome; no peer-reviewed screening results yet.
GC Genome's blood test from South Korea, launched in 2023 for six cancers, built on a method published with KAIST.
Ajinomoto's Japanese blood test that ranks the risk of several cancers separately from amino acid levels; in a validation of 10,245 people it found 34 cancers.
ClearNote Health's blood test for several cancers, one of the two tests in the US National Cancer Institute's randomised Vanguard study, with no published performance figures yet.
A Chinese blood test that measures physical properties of blood rather than molecules; its developer has since turned to a different business, and the test's status is unclear.
IMBdx's blood test from South Korea, offered at screening centres there, which in a laboratory study detected nine in ten cancers including stage I.
Exact Sciences' multi-cancer blood test, sold since 2025 as a lab test that has not been through FDA approval; it says whether a cancer signal is present but not where, so a positive result leads to scans.
The Johns Hopkins blood test that first showed one draw could find several cancers and point to the organ; its approach passed to Thrive Earlier Detection and then to Exact Sciences, whose Cancerguard test followed.
A German blood test that measures how blood proteins change shape; the only studies are small, run with the inventor, and do not say how often it finds early cancers.
A Glasgow company's blood test that shines infrared light through serum to look for cancer; it is sold in the UK for brain tumours, and the multi-cancer version is still in study.
A test in development from Elypta in Sweden that reads sugar molecules in urine and blood rather than DNA, aiming to flag many cancers including some that DNA tests find hard to see.
A research blood test that looks for six digestive-system cancers at once and predicts which organ the signal comes from.
GRAIL's blood test that looks for a signal from more than 50 cancers at once; an FDA advisory panel voted in its favour in September 2026, but in the NHS-Galleri randomised trial three yearly tests did not reduce the number of cancers found at a late stage.
A Japanese urine test that uses the sense of smell of tiny worms; it is sold directly to the public in Japan, does not say which cancer, and in a real-world analysis about 2 in 100 people with a positive result were found to have cancer (about 12 in 100 after allowing for cancers the follow-up scan can miss).
An experimental blood test that reads a handful of proteins, with different panels for men and women, to find many early cancers; so far it has been tried only on a few hundred stored samples.
VolitionRx's blood test that measures DNA packaging released by dying cells; a version is sold for dogs, and the human multi-cancer test is at preprint stage.
SeekIn's low-cost protein blood test for 14 cancers, designed for countries that cannot afford DNA sequencing; it finds about six in ten cancers but flags about one in twelve people without cancer.
A low-cost blood test from 20/20 BioLabs that measures a panel of protein tumour markers and is sold in the United States as a laboratory test without FDA review.
Burning Rock's methylation blood test from China for five or six cancers, with Breakthrough designations from the US and Chinese regulators but no approval yet.
Singlera's methylation blood test, tested on stored samples from a Chinese cohort, that reported finding cancers up to four years before they were diagnosed; it has not been confirmed in a prospective study.
A German blood test sold through a private health insurance add-on, which claims to signal cancer of any type; its published evidence is small studies and case reports.
Harbinger Health's blood test meant for the weeks between a doctor suspecting cancer and a diagnosis, pointing to where in the body a cancer may be; it is not offered as a screening test for well people.
SeekIn's multi-omic blood test that adds DNA sequencing to its protein test; in published studies it found about six to seven in ten cancers and about four in ten at stage I.
The first FDA-approved blood test for colorectal cancer screening (2024), now optionally reporting other cancers too.
Guardant Health's blood test for ten cancers, offered in the United States as an add-on report to its bowel cancer blood test and chosen by the US National Cancer Institute for its first randomised study of such tests.
Gene Solutions' low-cost blood test from Vietnam; in 9,024 people without symptoms about one in two hundred tested positive and four in ten of those had cancer.
An Amsterdam research test that reads RNA inside blood platelets and detected 18 cancer types in a laboratory study, though it often flagged people with other illnesses.
Datar Cancer Genetics' blood test that looks for clumps of tumour cells, sold privately in the UK; the developer's marketing figures go beyond what its own papers report.
This is the first randomised answer to whether a multi-cancer blood test changes outcomes, and for its main question the answer was no: adding the test to NHS care for three years did not lower the number of cancers diagnosed at stage III or IV. The stage IV result is a secondary finding with a confidence interval that touches no effect, and deaths have not yet been reported, so the trial continues to follow participants.
Supports the design choice of most current tests: methylation first, with proteins as an add-on rather than mutations.
The current honest statement of where early detection stands: no blood test is ready, and the research is about finding the threshold at which to operate.
These are the numbers GRAIL's US application rests on. Six in ten positive results were cancer and the predicted organ was usually right, but six in ten cancers diagnosed in the year were not flagged, and the study had no control group, so it cannot say whether testing changes outcomes.
It is the only peer-reviewed stage-by-stage figure for the Cancerguard approach, and it describes a development classifier at 98.5% specificity, not the launched test, which Exact Sciences says runs at 97.4% specificity.
For someone offered the test, these are the numbers that describe what a result means in an NHS population: about 1 in 100 tests came back positive each year, between 46 and 58 in 100 positives were cancer, and a negative result left about 1 in 100 with an undetected cancer within the year. The test found between a quarter and a third of all cancers diagnosed in a screening round, and about half to two thirds of the 12 cancer types it was designed to find. Whether finding them this way reduces late-stage diagnoses is the primary question, and this paper says only that the answer was no; the primary-endpoint paper had not appeared on Europe PMC by 23 September 2026.
Consistent across sites and platforms, with the same limit as before: specificity too low for population screening without a second test.
One of few multi-cancer tests with a stage I figure above one in three, from a case-control set; the prospective figures rest on few cancers.
Query for this technology: (TITLE:"multi-cancer early detection" OR ABSTRACT:"multi-cancer early detection" OR TITLE:"multicancer early detection" OR ABSTRACT:"multicancer early detection" OR TITLE:"MCED" OR ABSTRACT:"MCED"). Results are unfiltered search hits about Multi-cancer early detection (MCED), not a curated reading list.
Shares Yonsei high-sensitivity circulating tumour DNA test for multi-cancer diagnosis and residual disease, CAMPERR (Adela methylome test for early detection and residual disease), ESMO recommendations on the use of circulating tumour DNA assays for patients with cancer: a report from the ESMO Precision Medicine Working Group, Adela multi-cancer methylome test and the tag precision.
Shares ESMO recommendations on the use of circulating tumour DNA assays for patients with cancer: a report from the ESMO Precision Medicine Working Group, Bank yearly blood from cancer survivors so future tests can be validated, Tumour-informed versus tumour-naive ctDNA assays, Cell-free DNA (cfDNA) and the tag precision.
Shares Guy's and St Thomas' NHS Foundation Trust / King's Health Partners Cancer Centre, Paths to cures: interception, eradication, control, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question and the tag precision.
Shares Burning Rock Biotech, Lucence, Guardant Health, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors and the tag precision.
Shares Cell-free DNA (cfDNA), Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA) and the tag precision.
Shares ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment, Circulating tumour DNA (ctDNA), Liquid biopsy (ctDNA) and the tag precision.
Shares Hepatocellular carcinoma, Pancreatic ductal adenocarcinoma, Colorectal cancer and the tag precision.
Shares Advanced Research Projects Agency for Health and the tag precision.
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