{"entity":{"id":"stage-shift","kind":"term","name":"Stage shift","aka":[],"tldr":"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.","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Cancer_staging","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Cancer_staging"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":["mced","mammography"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["nhs-galleri"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Diagnostics & imaging"},"route":"/terms/stage-shift/","neighbours":{"technology":[{"id":"breath-vocs","kind":"technology","name":"Breath and volatile-organic-compound detection","route":"/technologies/breath-vocs/"},{"id":"gastric-endoscopic-screening","kind":"technology","name":"Gastric cancer endoscopic screening (East Asia)","route":"/technologies/gastric-endoscopic-screening/"},{"id":"pancreatic-surveillance","kind":"technology","name":"High-risk pancreatic surveillance (CAPS / PRECEDE)","route":"/technologies/pancreatic-surveillance/"},{"id":"mammography","kind":"technology","name":"Mammography & tomosynthesis","route":"/technologies/mammography/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"},{"id":"nhs-targeted-lung-health-check","kind":"technology","name":"NHS Targeted Lung Health Check (lung cancer screening programme)","route":"/technologies/nhs-targeted-lung-health-check/"},{"id":"total-body-pet-screening","kind":"technology","name":"Total-body PET for screening and ultra-low-dose imaging","route":"/technologies/total-body-pet-screening/"}],"trial":[{"id":"nhs-galleri","kind":"trial","name":"NHS-Galleri","route":"/trials/nhs-galleri/"},{"id":"ukctocs","kind":"trial","name":"UKCTOCS","route":"/trials/ukctocs/"},{"id":"vanguard-study","kind":"trial","name":"Vanguard Study (NCI Cancer Screening Research Network)","route":"/trials/vanguard-study/"}],"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"term":[{"id":"caps-consortium-pancreatic-screening","kind":"term","name":"CAPS: the Cancer of the Pancreas Screening consortium and its surveillance studies (CAPS1 to CAPS5)","route":"/terms/caps-consortium-pancreatic-screening/"},{"id":"ccga-study","kind":"term","name":"CCGA: the Circulating Cell-free Genome Atlas behind the Galleri methylation test","route":"/terms/ccga-study/"},{"id":"detect-a-study","kind":"term","name":"DETECT-A: a blood test plus PET-CT to screen 10,006 women with no symptoms","route":"/terms/detect-a-study/"},{"id":"early-detection-term","kind":"term","name":"Early detection","route":"/terms/early-detection-term/"},{"id":"emergency-presentation","kind":"term","name":"Emergency presentation (route to diagnosis)","route":"/terms/emergency-presentation/"},{"id":"familial-pancreatic-cancer","kind":"term","name":"Familial pancreatic cancer and inherited risk (who qualifies for surveillance)","route":"/terms/familial-pancreatic-cancer/"},{"id":"incidence-vs-prevalence","kind":"term","name":"Incidence versus prevalence","route":"/terms/incidence-vs-prevalence/"},{"id":"mortality","kind":"term","name":"Mortality","route":"/terms/mortality/"},{"id":"new-onset-diabetes-pancreatic-cancer","kind":"term","name":"New-onset diabetes as a signal of pancreatic cancer (and the ENDPAC score)","route":"/terms/new-onset-diabetes-pancreatic-cancer/"},{"id":"bowel-cancer-screening-uk","kind":"term","name":"NHS bowel cancer screening programme","route":"/terms/bowel-cancer-screening-uk/"},{"id":"overdiagnosis","kind":"term","name":"Overdiagnosis","route":"/terms/overdiagnosis/"},{"id":"screening","kind":"term","name":"Screening","route":"/terms/screening/"},{"id":"cancer-stage","kind":"term","name":"Stage","route":"/terms/cancer-stage/"},{"id":"surrogate-endpoint","kind":"term","name":"Surrogate endpoint","route":"/terms/surrogate-endpoint/"},{"id":"tnm-breast-cancer-editions","kind":"term","name":"Which staging edition a breast report uses: UICC TNM 8, TNM 9 and the AJCC prognostic stage","route":"/terms/tnm-breast-cancer-editions/"}],"idea":[{"id":"idea-prev-live-stage-dashboard","kind":"idea","name":"A live national dashboard of stage at diagnosis as the scorecard for early detection","route":"/ideas/idea-prev-live-stage-dashboard/"},{"id":"idea-moon-population-interception","kind":"idea","name":"A whole-population cancer interception programme: risk-stratify every adult, detect and intercept early","route":"/ideas/idea-moon-population-interception/"},{"id":"idea-prev-mced-stage-endpoint-surrogate","kind":"idea","name":"Let MCED trials read out on late-stage incidence, with mortality follow-up mandated","route":"/ideas/idea-prev-mced-stage-endpoint-surrogate/"},{"id":"idea-moon-indolence-classifiers-with-screening","kind":"idea","name":"Molecular indolence classifiers bundled with every screening programme","route":"/ideas/idea-moon-indolence-classifiers-with-screening/"},{"id":"idea-non-endoscopic-barretts-screening","kind":"idea","name":"Non-endoscopic screening for Barrett's oesophagus and early adenocarcinoma","route":"/ideas/idea-non-endoscopic-barretts-screening/"},{"id":"idea-prev-open-stage-shift-microsimulation","kind":"idea","name":"Open-source models that translate stage shift into lives saved, for every cancer","route":"/ideas/idea-prev-open-stage-shift-microsimulation/"},{"id":"idea-prev-pay-for-prevention-outcomes","kind":"idea","name":"Pay insurers and health systems for cancers prevented and caught early","route":"/ideas/idea-prev-pay-for-prevention-outcomes/"},{"id":"idea-prev-mced-registry-randomised","kind":"idea","name":"Registry-based randomised MCED trial: a million people, no study visits","route":"/ideas/idea-prev-mced-registry-randomised/"},{"id":"idea-data-ai-screening-endpoints","kind":"idea","name":"Require stage-shift or interval-cancer endpoints for AI in cancer screening","route":"/ideas/idea-data-ai-screening-endpoints/"}],"roadmap":[{"id":"ctdna-tests","kind":"roadmap","name":"ctDNA tests roadmap: from a curiosity in plasma to blood tests that decide treatment","route":"/roadmaps/ctdna-tests/"},{"id":"early-detection-roadmap","kind":"roadmap","name":"Early detection roadmap: organ screening → blood tests for many cancers","route":"/roadmaps/early-detection-roadmap/"}],"person":[{"id":"katie-couric","kind":"person","name":"Katie Couric","route":"/people/katie-couric/"}],"bottleneck":[{"id":"b-metastasis-biology","kind":"bottleneck","name":"Metastasis is understood least and studied last","route":"/bottlenecks/b-metastasis-biology/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"paper":[{"id":"paper-detect-a-science-2020","kind":"paper","name":"DETECT-A: a blood test plus PET-CT found treatable cancers in 10,000 women with no symptoms","route":"/key-papers/paper-detect-a-science-2020/"},{"id":"paper-nelson-nejm-2020","kind":"paper","name":"NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms","route":"/key-papers/paper-nelson-nejm-2020/"},{"id":"paper-nhs-galleri-design-cancers-2022","kind":"paper","name":"NHS-Galleri: design of the largest randomised trial of a multi-cancer blood test","route":"/key-papers/paper-nhs-galleri-design-cancers-2022/"},{"id":"paper-nlst-nejm-2011","kind":"paper","name":"NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers","route":"/key-papers/paper-nlst-nejm-2011/"},{"id":"paper-pathfinder-lancet-2023","kind":"paper","name":"PATHFINDER: the first prospective test of a multi-cancer blood test in people without symptoms","route":"/key-papers/paper-pathfinder-lancet-2023/"},{"id":"paper-nhs-galleri-performance-nat-med-2026","kind":"paper","name":"Performance of a multi-cancer early detection test in the randomized controlled NHS-Galleri trial","route":"/key-papers/paper-nhs-galleri-performance-nat-med-2026/"}],"institution":[{"id":"erasmus-mc","kind":"institution","name":"Erasmus MC Cancer Institute","route":"/institutions/erasmus-mc/"},{"id":"kaiser-permanente-research","kind":"institution","name":"Kaiser Permanente Division of Research","route":"/institutions/kaiser-permanente-research/"},{"id":"ncc-korea","kind":"institution","name":"National Cancer Center Korea","route":"/institutions/ncc-korea/"}],"pathway":[{"id":"basement-membrane-tissue-barriers","kind":"pathway","name":"Basement membrane & tissue barriers","route":"/pathways/basement-membrane-tissue-barriers/"}]}}