# Stage shift

Source: https://onco.cc/terms/stage-shift/  
OnCo record `stage-shift` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Stage shift means finding more cancers early and fewer late; it is the measurable goal of screening.

## Summary

Stage shift is the observable goal of screening: more cancers found at an early stage and fewer found late. It is the primary endpoint of the NHS-Galleri trial, defined as a reduction in the incidence of stage III and IV disease. A stage shift does not by itself prove that a screening test saves lives, because lead-time bias, length-time bias and overdiagnosis can all produce one, but it is a necessary precondition for any such benefit. The term is linked to the Multi-cancer early detection (MCED) and Mammography & tomosynthesis technologies and is referenced by UKCTOCS, High-risk pancreatic surveillance, the early detection roadmap, the bottleneck on late-found cancers and an idea on letting MCED trials read out on late-stage incidence.

## Fields

- Kind: Term
- Last checked: 2026-09-04

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Cancer_staging
- Wikipedia: https://en.wikipedia.org/wiki/Cancer_staging

## Connected records

- technologies: [Breath and volatile-organic-compound detection](https://onco.cc/technologies/breath-vocs/), [Gastric cancer endoscopic screening (East Asia)](https://onco.cc/technologies/gastric-endoscopic-screening/), [High-risk pancreatic surveillance (CAPS / PRECEDE)](https://onco.cc/technologies/pancreatic-surveillance/), [Mammography & tomosynthesis](https://onco.cc/technologies/mammography/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/), [NHS Targeted Lung Health Check (lung cancer screening programme)](https://onco.cc/technologies/nhs-targeted-lung-health-check/), [Total-body PET for screening and ultra-low-dose imaging](https://onco.cc/technologies/total-body-pet-screening/)
- trials: [NHS-Galleri](https://onco.cc/trials/nhs-galleri/), [UKCTOCS](https://onco.cc/trials/ukctocs/), [Vanguard Study (NCI Cancer Screening Research Network)](https://onco.cc/trials/vanguard-study/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- terms: [CAPS: the Cancer of the Pancreas Screening consortium and its surveillance studies (CAPS1 to CAPS5)](https://onco.cc/terms/caps-consortium-pancreatic-screening/), [CCGA: the Circulating Cell-free Genome Atlas behind the Galleri methylation test](https://onco.cc/terms/ccga-study/), [DETECT-A: a blood test plus PET-CT to screen 10,006 women with no symptoms](https://onco.cc/terms/detect-a-study/), [Early detection](https://onco.cc/terms/early-detection-term/), [Emergency presentation (route to diagnosis)](https://onco.cc/terms/emergency-presentation/), [Familial pancreatic cancer and inherited risk (who qualifies for surveillance)](https://onco.cc/terms/familial-pancreatic-cancer/), [Incidence versus prevalence](https://onco.cc/terms/incidence-vs-prevalence/), [Mortality](https://onco.cc/terms/mortality/), [New-onset diabetes as a signal of pancreatic cancer (and the ENDPAC score)](https://onco.cc/terms/new-onset-diabetes-pancreatic-cancer/), [NHS bowel cancer screening programme](https://onco.cc/terms/bowel-cancer-screening-uk/), [Overdiagnosis](https://onco.cc/terms/overdiagnosis/), [Screening](https://onco.cc/terms/screening/), [Stage](https://onco.cc/terms/cancer-stage/), [Surrogate endpoint](https://onco.cc/terms/surrogate-endpoint/), [Which staging edition a breast report uses: UICC TNM 8, TNM 9 and the AJCC prognostic stage](https://onco.cc/terms/tnm-breast-cancer-editions/)
- ideas: [A live national dashboard of stage at diagnosis as the scorecard for early detection](https://onco.cc/ideas/idea-prev-live-stage-dashboard/), [A whole-population cancer interception programme: risk-stratify every adult, detect and intercept early](https://onco.cc/ideas/idea-moon-population-interception/), [Let MCED trials read out on late-stage incidence, with mortality follow-up mandated](https://onco.cc/ideas/idea-prev-mced-stage-endpoint-surrogate/), [Molecular indolence classifiers bundled with every screening programme](https://onco.cc/ideas/idea-moon-indolence-classifiers-with-screening/), [Non-endoscopic screening for Barrett's oesophagus and early adenocarcinoma](https://onco.cc/ideas/idea-non-endoscopic-barretts-screening/), [Open-source models that translate stage shift into lives saved, for every cancer](https://onco.cc/ideas/idea-prev-open-stage-shift-microsimulation/), [Pay insurers and health systems for cancers prevented and caught early](https://onco.cc/ideas/idea-prev-pay-for-prevention-outcomes/), [Registry-based randomised MCED trial: a million people, no study visits](https://onco.cc/ideas/idea-prev-mced-registry-randomised/), [Require stage-shift or interval-cancer endpoints for AI in cancer screening](https://onco.cc/ideas/idea-data-ai-screening-endpoints/)
- roadmaps: [ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment](https://onco.cc/roadmaps/ctdna-tests/), [Early detection roadmap: organ screening → blood tests for many cancers](https://onco.cc/roadmaps/early-detection-roadmap/)
- people: [Katie Couric](https://onco.cc/people/katie-couric/)
- bottlenecks: [Metastasis is understood least and studied last](https://onco.cc/bottlenecks/b-metastasis-biology/), [The hardest cancers are found late](https://onco.cc/bottlenecks/b-early-detection/)
- key papers: [DETECT-A: a blood test plus PET-CT found treatable cancers in 10,000 women with no symptoms](https://onco.cc/key-papers/paper-detect-a-science-2020/), [NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms](https://onco.cc/key-papers/paper-nelson-nejm-2020/), [NHS-Galleri: design of the largest randomised trial of a multi-cancer blood test](https://onco.cc/key-papers/paper-nhs-galleri-design-cancers-2022/), [NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers](https://onco.cc/key-papers/paper-nlst-nejm-2011/), [PATHFINDER: the first prospective test of a multi-cancer blood test in people without symptoms](https://onco.cc/key-papers/paper-pathfinder-lancet-2023/), [Performance of a multi-cancer early detection test in the randomized controlled NHS-Galleri trial](https://onco.cc/key-papers/paper-nhs-galleri-performance-nat-med-2026/)
- institutions: [Erasmus MC Cancer Institute](https://onco.cc/institutions/erasmus-mc/), [Kaiser Permanente Division of Research](https://onco.cc/institutions/kaiser-permanente-research/), [National Cancer Center Korea](https://onco.cc/institutions/ncc-korea/)
- pathways: [Basement membrane & tissue barriers](https://onco.cc/pathways/basement-membrane-tissue-barriers/)

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JSON: https://onco.cc/api/v1/entities/stage-shift.json