Key takeaways
- Primary endpoint not met, but promising trends observed – The Galleri® test did not achieve a statistically significant reduction in combined Stage III–IV cancer diagnoses, but showed favourable shifts toward earlier detection in 12 high-risk cancers.
- Reduction in late-stage and emergency cancers – Adding Galleri to standard screening led to meaningful decreases in Stage IV diagnoses and fewer cancers detected via emergency presentations, which are associated with higher mortality.
- Substantial increase in overall detection and early-stage cancers – Annual Galleri screening with standard care quadrupled overall cancer detection rates and increased Stage I–II detections, suggesting potential long-term population benefits as follow-up continues.
Grail, Inc. has released topline results from the NHS-Galleri trial, a landmark randomized study assessing the impact of annual multi-cancer screening with the Galleri® test in the NHS, UK. Over three years, the trial enrolled 142,000 participants aged 50–77.
The trial’s primary goal of a statistically significant reduction in combined Stage III–IV cancer diagnoses was not met. Nevertheless, the intervention arm exhibited a favourable trend toward fewer late-stage cancers within a pre-specified group of 12 deadly cancer types, including colorectal, lung, pancreatic and ovarian cancers. These cancers typically present at advanced stages, making early detection particularly critical.
Notably, adding Galleri to standard screening led to a substantial and clinically meaningful reduction in Stage IV diagnoses, with decreases exceeding 20% in the second and third screening rounds. Early-stage (Stage I–II) diagnoses also rose significantly for these high-risk cancers, suggesting the test may shift detection toward stages more amenable to curative treatment.
The trial demonstrated a four-fold increase in overall cancer detection for breast, colorectal, cervical and high-risk lung cancers compared to standard screening alone. Additionally, the number of cancers detected through emergency presentations – often linked to higher mortality and healthcare costs – was reduced in the Galleri arm.
“As an oncologist, I see how profound the difference is between Stage III and Stage IV disease,” said Professor Charles Swanton (University College Hospital, London, UK and one of the NHS-Galleri trial’s chief investigators). “When cancer is detected before distant metastatic spread, we can often treat with curative intent, combining surgery, radiotherapy and systemic therapy in an effort to eradicate all disease. Once distant metastases are established, treatment typically shifts toward long-term disease control and symptom management; durable cures become uncommon in most solid tumours. Reducing the proportion of patients diagnosed with metastatic disease is therefore not merely a statistical aim, it dramatically increases the number of patients for whom eradication of disease and cure is possible.”
While a higher-than-anticipated incidence of stage III cancers was observed, analyses suggest diagnostic resolution improves as clinicians gain experience with Galleri. Grail plans to extend follow-up by 6–12 months, which may further clarify the test’s population-level impact. Detailed results are scheduled for presentation at the ASCO 2026 Annual Meeting.
Although the NHS-Galleri trial did not meet its primary endpoint, the observed reductions in late-stage diagnoses, increased early detection and improved overall cancer identification underscore the potential of multi-cancer screening to complement existing programs and improve outcomes for high-risk cancers.
References
- Grail. Landmark NHS-Galleri Trial Demonstrates a Substantial Reduction in Stage IV Cancer Diagnoses, Increased Stage I and II Detection of Deadly Cancers, and Four-Fold Higher Cancer Detection Rate. Available at: https://grail.com/press-releases/landmark-nhs-galleri-trial-demonstrates-a-substantial-reduction-in-stage-iv-cancer-diagnoses-increased-stage-i-and-ii-detection-of-deadly-cancers-and-four-fold-higher-cancer-detection-rate/ (Date last accessed: 25 February 2026)
- Pharmawand. Prospective trial assessing Galleri multi-cancer early detection test does not meet primary endpoints. Available at: https://data.pharmawand.co.uk/members/news.aspx?entityID=29083&alrtPrfID=1589 (Date last accessed: 25 February 2026)
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This content has been developed independently by Touch Medical Media for touchHAEMATOLOGY. Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
Cite: Galleri® multi-cancer test reduces late-stage diagnoses in landmark UK study. touchHAEMATOLOGY. 26th February 2026.
Editor: Sophie Nickelson, Editorial Director
Disclosures: This short article was prepared by touchHAEMATOLOGY. The content was developed and edited by human editors. No fees or funding were associated with its publication. touchHAEMATOLOGY utilize AI as an editorial tool (ChatGPT (GPT-4o) [Large language model]. https://chat.openai.com/chat).
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