Multi-Cancer Early Detection Tests, Side by Side


The tests sold in the US today, side by side, with a source next to every value.

This page is for informational purposes only and is not medical advice. Every value below is reproduced from a company page or a published study, linked next to it, without interpretation, and none of it is a recommendation. If you are considering one of these tests, please discuss it with your own clinician.

Three multi-cancer early detection tests can be ordered in the United States today: Galleri, Cancerguard, and Caris Detect. The table below puts what each company and each published study has reported side by side, with a link to the source next to every value. "Not reported" means I could not find the value on any company or study page.

Last checked September 6, 2026.

At a glance

Galleri
GRAIL, Inc.
Price
$949 (GRAIL's published price before discounts) [20]
Evidence
Randomized trial and prospective screening study [14]
Cancerguard
Exact Sciences (Abbott)
Price
$689; telehealth consultation included when ordered through cancerguard.com [19]
Evidence
Case-control studies only [6]
Caris Detect
Caris Life Sciences
Price
$3,500 through Everlywell, cash-pay [3]
Evidence
Company press release only [18]
Shield MCD*
Guardant Health
Price
No US price
Evidence
Case-control conference data only [10]

* Not yet available in the US.

Full comparison

 
Galleri
GRAIL, Inc.
Cancerguard
Exact Sciences (Abbott)
Caris Detect
Caris Life Sciences
Shield MCD*
Guardant Health
What it looks for
How many cancers the company says the test can pick up, who it is meant for, and which cancers it is weak on.
Cancer types claimed by the companySignal shared by more than 50 types of cancer [1]Signals associated with 50+ cancer types and subtypes [2]Signals from 55+ types of cancer [3]10 cancers: bladder, breast, colorectal, esophageal, gastric, liver, lung, ovarian, pancreatic, prostate [4]
Intended population, as stated by the companyRecommended for adults with an elevated risk for cancer, such as those aged 50 or older [5]Adults ages 50-84 with no known cancer diagnosis in the preceding 3 years [6]Adults 21 and older [7]Adults 45 and older at average risk [8]
Cancers with low sensitivity, as stated by the companyLow sensitivity for cancers that shed little DNA, for example brain, skin, and early breast and prostate cancers [1]Not reportedBreast had the lowest sensitivity (53%) in the Achieve 1 study, per a news report [9]Per-cancer sensitivity ranged from 96% (esophageal and gastric) down to 21% (prostate) in the AACR 2025 case-control study [10]
Technology, as described by the companyNext-generation sequencing of methylation patterns in cell-free DNA, with a predicted cancer signal origin [11]Methylated cell-free DNA by real-time PCR plus protein biomarkers by immunoassay [6]Whole genome and whole transcriptome sequencing with an artificial intelligence model [12]Methylation patterns and cell-free DNA fragment positions (fragmentomics), with genomic analysis [13]
Performance in screening studies
These numbers come from studies that gave the test to healthy people and then followed them. This is the closest thing to what would happen if you took the test.
Sensitivity, all cancers39.3% (95% CI 34.9-44.0), 12-month episode sensitivity; PATHFINDER 2, 32,007 participants [14]No prospective screening data for the commercial testNo prospective screening dataNo prospective screening data; enrolled in the NCI Vanguard study (up to 24,000 people ages 45-75) since July 2025 [15]
Sensitivity, 12 pre-specified deadly cancers69.8% (95% CI 62.8-76.0); PATHFINDER 2 [14]Not reportedNot reportedNot reported
Specificity99.6% (95% CI 99.6-99.7); PATHFINDER 2 [14]Not reportedNot reportedNot reported
Positive predictive value60.3% (95% CI 54.5-65.8); 173 cancers among 287 positive results; PATHFINDER 2 [14]Not reportedNot reportedNot reported
Cancer signal origin accuracy91.3% (95% CI 86.2-94.7); PATHFINDER 2 [14]Not applicable; the test does not report a cancer signal origin [6]Not reportedNot reported
Share of detected cancers at stage I-II53.0% (80 of 151); PATHFINDER 2 [14]Not reportedNot reportedNot reported
Randomized trial: primary endpointNot met; stage III and IV cancers combined, incidence rate ratio 1.03; NHS-Galleri [16]Not reportedNot reportedNot reported
Randomized trial: stage IV cancersReduced 14% overall (incidence rate ratio 0.86); 22% and 26% in screening rounds 2 and 3; NHS-Galleri [16]Not reportedNot reportedNot reported
Mortality dataNone reported [16]Not reportedNot reportedNot reported
Performance in case-control studies
These studies mix known cancer patients with healthy volunteers. They make a test look better than it will in real screening.
Sensitivity, overall51.5% (95% CI 49.6-53.3); CCGA validation set, 4,077 participants [17]55.6% (95% CI 49.0-62.0), excluding breast and prostate; validation study, 223 cancers of 17 types and 800 controls. The company notes real-world sensitivity may be lower than in case-control data [6]Not reported60%; blinded case-control study, 778 participants (403 with cancer), AACR 2025 [10]
Sensitivity by stageStage I 16.8%, II 40.4%, III 77.0%, IV 90.1%; CCGA [17]Stage I 26.8%, II 42.9%, III 63.6%, IV 89.3%; validation study, excluding breast and prostate [6]Stage I 56.8%, II 67.7%, III 79.0%, IV 98.6%; Achieve 1 study, 3,014 subjects enrolled on the basis of high-risk screening, symptoms, or a mass on imaging; reported in a company press release, not published or peer reviewed [18]Not reported
Specificity99.5% (95% CI 99.0-99.8); CCGA [17]97.4% (95% CI 96.0-98.3); validation study [6]99.2% in 141 asymptomatic subjects; 96.0% in 2,051 subjects with benign conditions or high risk; Achieve 1; reported in a company press release, not published or peer reviewed [18]98.5%; AACR 2025 case-control study [10]
Evidence and practical details
A randomized trial is the strongest evidence. A company brochure is the weakest.
Evidence, as reportedRandomized trial (NHS-Galleri) and prospective screening study (PATHFINDER 2), both presented at ASCO 2026 as abstracts; the earlier PATHFINDER study was published in The Lancet in 2023 [14]Case-control studies reported in a company brochure and a conference abstract [6]Company press release only; not peer reviewed; not a screening population [18]Case-control conference data only (AACR 2025, ASCO 2025) [10]
Time to results, as stated by the companyAbout 2 weeks after the sample arrives at the lab; up to 4 weeks in some cases [1]About 2 weeks after the lab receives the sample [19]About 2 to 3 weeks after the blood draw [3]Not reported

* Not yet available in the US.

How to read the numbers

Sensitivity (cancers it caught)
Of the people who had cancer, the share the test flagged. A 40% sensitivity means it missed 6 in 10.
Specificity (false alarms)
Of the people who did not have cancer, the share the test correctly left alone. 99.5% specificity means about 5 false alarms per 1,000 healthy people tested. 97.4% means about 26.
PPV (if it says positive, odds it is cancer)
Of everyone who got a positive result, the share who turned out to have cancer. This is the number a patient holding a positive result cares about, and it depends on how common cancer is in the people being tested. It can only be measured in a real screening study.
Case-control study
Known cancer patients and healthy volunteers are tested and the test is scored on telling them apart. Useful for development, but it overstates real-world performance, especially for early-stage cancers.
Prospective screening study
The test is given to people with no known cancer, results are returned, and everyone is followed for a year. This is the design that produces a real PPV.
Randomized trial
People are randomly assigned to get the test or not, and the two groups are compared on an outcome like late-stage cancer or death. Only Galleri has one.
LDT (lab-developed test)
A test sold by a single certified lab without FDA review of its performance claims. All four tests on this page are lab-developed tests.
Cancer signal origin (CSO)
The test's guess at which organ the signal came from, which guides the workup after a positive result.

Studies behind the numbers

StudyTestDesignParticipantsWhere reported
PATHFINDER 2 [14]GalleriProspective screening study, single arm, results returned to participants35,878 enrolled; 32,007 in the performance analysisASCO 2026, abstract LBA10509 (J Clin Oncol 2026;44(17_suppl))
NHS-Galleri [16]GalleriRandomized controlled trial, three annual screening rounds142,250ASCO 2026, abstract LBA100; GRAIL press release May 30, 2026
PATHFINDER [22]GalleriProspective screening study, results returned to participants6,661 evaluableLancet 2023;402:1251-60 (summarized in The ASCO Post, October 19, 2023)
CCGA validation substudy [17]GalleriCase-control, independent validation set4,077 (2,823 with cancer, 1,254 without)Annals of Oncology 2021;32(9):1167-77
Cancerguard development and validation studies [6]CancerguardCase-control; headline figures exclude breast and prostateDevelopment: 729 cancers, 2,434 controls. Validation: 324 cancers, 800 controlsCancerguard clinician brochure (rev. 10/2025); not peer reviewed
Achieve 1 [18]Caris DetectEnrolled on the basis of high-risk screening, symptoms, or a mass on imaging; not a screening population3,014 evaluableCaris press release March 31, 2026; not peer reviewed
Shield MCD case-control study [10]Shield MCDBlinded case-control778 (403 with cancer)AACR 2025; Guardant press release April 29, 2025
NCI Vanguard Study [15]Shield MCDFeasibility study for future randomized trials of multi-cancer testsUp to 24,000, ages 45-75Ongoing; enrolling since July 2025

Sources

Each bracketed number on this page opens one of these. Values were confirmed against the linked page on September 6, 2026.

  1. Galleri patient FAQs (galleri.com) company page, accessed September 5, 2026
  2. Cancerguard home page (cancerguard.com) company page, accessed September 5, 2026
  3. Caris Detect product page (Everlywell) retail partner page, accessed September 5, 2026
  4. Guardant Health press release: Shield MCD launch in Hong Kong, Singapore, and the Philippines company press release, March 16, 2026
  5. Galleri provider FAQs (galleri.com) company page, accessed September 5, 2026
  6. Cancerguard clinician brochure: test information for healthcare providers, rev. 10/2025 (Exact Sciences) company brochure, October 2025
  7. Caris Detect product page (Caris Life Sciences) company page, accessed September 5, 2026
  8. Guardant Health press release: FDA grants Breakthrough Device designation to Shield MCD company press release, June 3, 2025
  9. Fierce Biotech: Caris Life Sciences launches cancer blood test Caris Detect news report, July 6, 2026
  10. Guardant Health press release: Shield MCD case-control data across 10 tumor types, AACR 2025 company press release, April 29, 2025
  11. FDA: September 23, 2026 Molecular and Clinical Genetics Panel meeting announcement (Galleri PMA) FDA document, 2026
  12. Caris Life Sciences press release: launch of Caris Detect company press release, July 1, 2026
  13. Shield test entry in the NIH Genetic Testing Registry, submitted by Guardant Health test registry entry, accessed September 6, 2026
  14. Giridhar K et al. Safety and performance results from PATHFINDER 2, a registrational study of an MCED test in an intended-use population. J Clin Oncol 2026;44(17_suppl):LBA10509 (ASCO 2026 abstract) conference abstract, May 31, 2026
  15. Guardant Health press release: first patient enrolled in the NCI Vanguard Study company press release, July 15, 2025
  16. GRAIL press release: full results from the NHS-Galleri trial, ASCO 2026 company press release, May 30, 2026
  17. Klein EA et al. Clinical validation of a targeted methylation-based multi-cancer early detection test using an independent validation set. Ann Oncol 2021;32(9):1167-77 peer-reviewed paper, September 2021
  18. Caris Life Sciences press release: Achieve 1 study final results company press release, March 31, 2026
  19. Cancerguard FAQs (cancerguard.com) company page, accessed September 5, 2026
  20. Galleri test cost page (galleri.com) company page, accessed September 5, 2026
  21. Shield blood test official site (shieldbloodtest.com) company page, accessed September 5, 2026
  22. Stenger M. Blood-based testing for multicancer early detection. The ASCO Post (summary of Schrag D et al., PATHFINDER, Lancet 2023;402:1251-60) news summary of a peer-reviewed trial, October 19, 2023
Disclosures. Before Stage One is written by Michael LaPelusa, MD in his personal capacity. Views expressed are his own and do not represent the views of any institution. Content is provided for informational purposes only and should not be relied upon as medical, legal, business, investment, or tax advice. Nothing here is a recommendation to undergo, avoid, prescribe, or order any medical test or treatment, nor a recommendation to buy or sell any security. Readers should consult their own physicians and advisers regarding clinical, financial, and legal decisions. The author does not hold positions in any company discussed unless explicitly disclosed in the post. See full disclosures.