For patients who walk into a GP surgery in England with persistent bloating or abdominal discomfort, the wait that follows can be one of the most anxious stretches of their lives. Symptoms like these are common and vague, and they can point to many conditions other than cancer. Now, more than 20,000 NHS patients aged 45 and over will be offered a chance to shorten that uncertainty: a simple blood test, taken at their GP practice, designed to spot early signs of cancer before more severe symptoms develop.
The trial, known as STRIDE-RCT, is being described as a world first. It will run across at least 200 GP practices and assess whether blood tests can detect prostate, ovarian, bowel, pancreatic, stomach, liver and other abdominal cancers. Most participants will be asked to give just one or two tubes of blood alongside their routine tests. The tests, developed by the University of Birmingham, use a range of the latest technology, including artificial intelligence and the measurement of proteins in the blood, and look for signs of several cancers in a single sample while suggesting where in the body they might originate.
The human stakes behind the trial are stark. Around 71,000 people in England are diagnosed with pancreatic, stomach, liver, ovarian or bowel cancer each year, and there are almost 35,000 deaths from these cancers. Abdominal cancers are often found too late. Around 9 in 10 people diagnosed with bowel cancer at stage 1 survive at least 5 years, compared with roughly one in 10 at stage 4. Catching these conditions earlier, when treatment is more effective, could save lives.
For the clinicians who see these patients every day, the trial addresses a familiar dilemma. Dr Anisha Patel, an NHS GP, author and bowel cancer survivor who was diagnosed with stage 3 bowel cancer at a young age, said she knows how much earlier diagnosis matters. The challenge in general practice, she explained, is that cancer symptoms can be vague and overlap with many other conditions, and a later diagnosis can mean fewer treatment options and poorer outcomes. She welcomed the trial as offering real hope, while stressing that listening to patients, taking their concerns seriously, following up persistent symptoms and ensuring screening attendance must remain at the heart of care.
Professor Aneel Bhangu, a consultant colorectal surgeon and Co-Chief Investigator of the trial, described the problem from the other side of the referral pathway. Too many patients with cancer reach him after months of vague symptoms that were hard to pin down, he said, while at the same time most people referred urgently do not have cancer, causing unnecessary worry and expense. The blood tests might help GPs tell the two apart, but he said we need to know for certain before they are used across the NHS, and the trial is designed to give that answer quickly.
The numbers underline why that distinction matters. Currently, just 2% to 6% of urgent referrals for cancer result in a diagnosis. By giving GPs another tool to decide who needs further tests, the technology aims to reduce that figure and free up appointments for those with a genuinely urgent need. A positive result will help a GP and patient decide whether an urgent referral is needed, though it is not by itself a confirmed cancer diagnosis.
Meanwhile, charities representing patients affected by these cancers also voiced support. Michelle Mitchell, Chief Executive of Cancer Research UK, noted that symptoms such as bloating and stomach pain are common and could have many causes, making it difficult for GPs to know when to investigate, and that some cancers may go undetected until a later stage when they are harder to treat. She called the trial an important step towards giving GPs better tools to navigate that uncertainty. Jodie Moffat, Director of Charitable Impact at Bowel Cancer UK, said the trial would help guide improvements in diagnosis and could make a positive difference to many lives. Alfie Bailey-Bearfield, Head of Policy and Influencing at Pancreatic Cancer UK, said new tools are desperately needed, noting that half of people with pancreatic cancer die within just 3 months of diagnosis, and that successful results could give many more people the very best chance of survival.
The trial is funded by the Office for Life Sciences through the National Institute for Health and Care Research, receiving up to £8.49 million of government funding. It will deliberately cover a broad range of inner-city, rural, seaside and deprived communities. Associate Professor Dmitri Nepogodiev, a consultant in public health at the University of Birmingham and Co-Chief Investigator, explained why: abdominal cancers are often found late, and people in the most deprived communities are more likely to be diagnosed in an emergency. The trial has been designed to include practices in inner cities, coastal towns and rural areas so the results apply to everyone the NHS serves.
Health Secretary Yvette Cooper said the earlier cancers are diagnosed, the more chance they can be successfully treated, and that the trial will establish whether simple blood tests can help GPs identify sooner the patients who need urgent support. Professor Peter Johnson, NHS National Clinical Director for Cancer, said detecting abdominal cancer early is notoriously difficult because symptoms can easily be mistaken for less serious conditions, but described the trial as the start of a revolution in cancer diagnosis. The trial will assess how well the tests work alongside GPs’ judgement before any decision is made on rolling them out nationwide, supporting one of the main ambitions of the National Cancer Plan for England: identifying cancers earlier and giving people the best chance of survival. For the tens of thousands of families touched by these cancers each year, the question now is whether a single tube of blood can change how early their story begins.