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A blood test that reads fragments of DNA shed by the tumour, so you can genotype or monitor cancer without a needle in the tumour.
Circulating tumour DNA assays (Guardant360 CDx, FoundationOne Liquid CDx) are approved companion diagnostics for EGFR, PIK3CA, ESR1, and others. Used when tissue is insufficient, to track resistance mutations (EGFR T790M, ESR1), and to follow clonal dynamics. Fragmentomics and methylation extend it to tumour-agnostic detection.
Cell-free DNA extracted from plasma; deep NGS with error suppression detects variants at <0.1% allele fraction.
Dependencies are what this technology cannot be delivered without: manufacturing steps, instruments, software, upstream methods. See its full chain on the map.
Camizestrant is an oral oestrogen-receptor degrader approved in September 2026 for a new kind of decision: switching treatment when a blood test shows resistance developing, before the cancer visibly grows.
Elacestrant was the first oral oestrogen-receptor degrader (2023), for ESR1-mutant breast cancer detected by blood test.
Adela's blood test in development for 20 cancer types, built on reading DNA methylation across the whole genome; no peer-reviewed screening results yet.
GC Genome's blood test from South Korea, launched in 2023 for six cancers, built on a method published with KAIST.
Ajinomoto's Japanese blood test that ranks the risk of several cancers separately from amino acid levels; in a validation of 10,245 people it found 34 cancers.
ClearNote Health's blood test for several cancers, one of the two tests in the US National Cancer Institute's randomised Vanguard study, with no published performance figures yet.
A Chinese blood test that measures physical properties of blood rather than molecules; its developer has since turned to a different business, and the test's status is unclear.
IMBdx's blood test from South Korea, offered at screening centres there, which in a laboratory study detected nine in ten cancers including stage I.
Exact Sciences' multi-cancer blood test, sold since 2025 as a lab test that has not been through FDA approval; it says whether a cancer signal is present but not where, so a positive result leads to scans.
The Johns Hopkins blood test that first showed one draw could find several cancers and point to the organ; its approach passed to Thrive Earlier Detection and then to Exact Sciences, whose Cancerguard test followed.
A German blood test that measures how blood proteins change shape; the only studies are small, run with the inventor, and do not say how often it finds early cancers.
The lung cancer gene test that became the first blood-based companion diagnostic the FDA ever approved.
A Glasgow company's blood test that shines infrared light through serum to look for cancer; it is sold in the UK for brain tumours, and the multi-cancer version is still in study.
A test in development from Elypta in Sweden that reads sugar molecules in urine and blood rather than DNA, aiming to flag many cancers including some that DNA tests find hard to see.
A research blood test that looks for six digestive-system cancers at once and predicts which organ the signal comes from.
The FDA-approved tissue (324 genes) and blood genomic tests that serve as companion diagnostics for dozens of drugs.
GRAIL's blood test that looks for a signal from more than 50 cancers at once; an FDA advisory panel voted in its favour in September 2026, but in the NHS-Galleri randomised trial three yearly tests did not reduce the number of cancers found at a late stage.
A blood test for leftover cancer after surgery that needs no tumour sample, so results come faster than tumour-informed tests.
A blood test that reads a tumour's mutations without a tissue biopsy and is the FDA-approved gateway to several targeted drugs.
A Japanese urine test that uses the sense of smell of tiny worms; it is sold directly to the public in Japan, does not say which cancer, and in a real-world analysis about 2 in 100 people with a positive result were found to have cancer (about 12 in 100 after allowing for cancers the follow-up scan can miss).
An experimental blood test that reads a handful of proteins, with different panels for men and women, to find many early cancers; so far it has been tried only on a few hundred stored samples.
VolitionRx's blood test that measures DNA packaging released by dying cells; a version is sold for dogs, and the human multi-cancer test is at preprint stage.
Exact Sciences' entry into the leftover-cancer blood test market, launched in 2025 for bowel cancer follow-up.
SeekIn's low-cost protein blood test for 14 cancers, designed for countries that cannot afford DNA sequencing; it finds about six in ten cancers but flags about one in twelve people without cancer.
A low-cost blood test from 20/20 BioLabs that measures a panel of protein tumour markers and is sold in the United States as a laboratory test without FDA review.
Burning Rock's methylation blood test from China for five or six cancers, with Breakthrough designations from the US and Chinese regulators but no approval yet.
Singlera's methylation blood test, tested on stored samples from a Chinese cohort, that reported finding cancers up to four years before they were diagnosed; it has not been confirmed in a prospective study.
A German blood test sold through a private health insurance add-on, which claims to signal cancer of any type; its published evidence is small studies and case reports.
NeoGenomics' personalised blood test for tiny amounts of leftover cancer, tracking up to 48 mutations from the patient's own tumour.
A blood test approved with adagrasib to find the KRAS G12C mutation in lung cancer when a tissue biopsy is not possible.
Harbinger Health's blood test meant for the weeks between a doctor suspecting cancer and a diagnosis, pointing to where in the body a cancer may be; it is not offered as a screening test for well people.
SeekIn's multi-omic blood test that adds DNA sequencing to its protein test; in published studies it found about six to seven in ten cancers and about four in ten at stage I.
The first FDA-approved blood test for colorectal cancer screening (2024), now optionally reporting other cancers too.
Guardant Health's blood test for ten cancers, offered in the United States as an add-on report to its bowel cancer blood test and chosen by the US National Cancer Institute for its first randomised study of such tests.
Signatera is Natera's tumour-informed blood test that tracks 16 mutations from each patient's own tumour to detect residual or returning cancer after surgery. Medicare covers it in colorectal, breast, bladder, lung and ovarian cancer and for immunotherapy monitoring, and in 2026 it selected the bladder cancer patients for the first approval based on circulating tumour DNA.
The second FDA-approved blood test for bowel cancer screening, from Freenome, sold by Abbott from late 2026.
Gene Solutions' low-cost blood test from Vietnam; in 9,024 people without symptoms about one in two hundred tested positive and four in ten of those had cancer.
An Amsterdam research test that reads RNA inside blood platelets and detected 18 cancer types in a laboratory study, though it often flagged people with other illnesses.
Datar Cancer Genetics' blood test that looks for clumps of tumour cells, sold privately in the UK; the developer's marketing figures go beyond what its own papers report.
The 48 most recent of 65 papers; see them all →
Residual-disease testing may not need the tumour to be sequenced first, which would remove the slowest step of tumour-informed assays; the comparison with tumour-informed results in the same patients is the evidence that matters.
This is the first randomised answer to whether a multi-cancer blood test changes outcomes, and for its main question the answer was no: adding the test to NHS care for three years did not lower the number of cancers diagnosed at stage III or IV. The stage IV result is a secondary finding with a confidence interval that touches no effect, and deaths have not yet been reported, so the trial continues to follow participants.
The current honest statement of where early detection stands: no blood test is ready, and the research is about finding the threshold at which to operate.
These are the numbers GRAIL's US application rests on. Six in ten positive results were cancer and the predicted organ was usually right, but six in ten cancers diagnosed in the year were not flagged, and the study had no control group, so it cannot say whether testing changes outcomes.
For someone offered the test, these are the numbers that describe what a result means in an NHS population: about 1 in 100 tests came back positive each year, between 46 and 58 in 100 positives were cancer, and a negative result left about 1 in 100 with an undetected cancer within the year. The test found between a quarter and a third of all cancers diagnosed in a screening round, and about half to two thirds of the 12 cancer types it was designed to find. Whether finding them this way reduces late-stage diagnoses is the primary question, and this paper says only that the answer was no; the primary-endpoint paper had not appeared on Europe PMC by 23 September 2026.
Together with the JCO Precision Oncology cohort this makes residual disease testing in biliary cancer prognostic to the same degree as in colon cancer. Nobody has yet shown that acting on it helps; that is the trial gap the ideas on this page name.
This is the validation study behind the July 2026 FDA approval of SimpleScreen CRC. For someone who will not take a stool test or colonoscopy it offers a real option for catching cancer, but because it misses most advanced polyps it prevents fewer cancers than the established tests, and a positive result still needs a colonoscopy.
Very wide confidence intervals from a small cohort, but the direction matches the larger 2026 analysis. Gallbladder cancer recurs early and distantly after re-resection, which is exactly the setting where a residual disease test could pick who gets more than capecitabine.
Query for this technology: (TITLE:"liquid biopsy" OR ABSTRACT:"liquid biopsy" OR TITLE:"circulating tumor DNA" OR ABSTRACT:"circulating tumor DNA" OR TITLE:"cell-free DNA" OR ABSTRACT:"cell-free DNA") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Liquid biopsy (ctDNA), not a curated reading list.
Shares ESMO recommendations on the use of circulating tumour DNA assays for patients with cancer: a report from the ESMO Precision Medicine Working Group, Maximilian Diehn, Personalis (Tempus), c-TRAK TN analysis: tissue-free versus tumour-informed ctDNA assays for residual disease in early triple-negative breast cancer and the tag precision.
Shares Queen Mary Hospital / University of Hong Kong, Champalimaud Foundation, Champalimaud Clinical Centre, Zhongshan Hospital, Fudan University, PDGFRA D842V-mutant GIST and the tag precision.
Shares Maximilian Diehn, HealthCare Global Enterprises, Champalimaud Foundation, Champalimaud Clinical Centre, A test to tell true oligometastatic disease from hidden widespread spread and the tag precision.
Shares The University of Kansas Cancer Center, National Cancer Center Hospital East, Locoregionally advanced nasopharyngeal carcinoma (stage III to IVA), Recurrent and metastatic nasopharyngeal carcinoma and the tag precision.
Shares Locoregionally advanced nasopharyngeal carcinoma (stage III to IVA), Cancer of unknown primary, favourable subsets, Oxford Cancer (Oxford University Hospitals and University of Oxford), Cancer of unknown primary (CUP) and the tag precision.
Shares Blood-based tumor mutational burden as a predictor of clinical benefit in non-small-cell lung cancer patients treated with atezolizumab, FoundationOne CDx / Liquid CDx, Diagnostics roadmap: stains → gene panels → blood tests that decide treatment, Comprehensive genomic profiling and the tag precision.
Shares Reference materials and open proficiency testing for residual disease tests, Watch the immune system's response in the blood three weeks in, Dormant cells and minimal residual disease, MRD / molecular residual disease testing and the tag precision.
Shares Stage IIB and IIC melanoma, High-risk early HR-positive breast cancer, Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes, Metastasis is understood least and studied last and the tag precision.
Open-source projects that implement or serve this technology, from OnCo's own catalogue: licence and last activity as the repository reported them on the day of the fetch. Listing is not endorsement; check the licence before reuse and the validation before clinical use.
Tools for working with unique molecular identifiers in sequencing reads, the duplex and consensus calling that deep ctDNA assays depend on.
Estimates tumour fraction in cell-free DNA from ultra-low-pass whole-genome sequencing, a workhorse of liquid biopsy research.
Code behind the DELFI cell-free DNA fragmentation approach to cancer detection, from the Velculescu lab at Johns Hopkins.
Nucleosome profiling of cell-free DNA to infer tumour phenotypes, such as subtype, from plasma sequencing.
Open-source software, hardware and data projects catalogued by a third party, the Open Medical Registry, that bear on this technology. Listing is not endorsement; check each project's own licence and validation before clinical use.
Identification of gene-fusions, including EML4-ALK
Detect somatic SNVs from deep targeted UMI-seq cfDNA
From the Open Medical Registry (openmedical.sh), an MIT-licensed catalogue of open-source medicine. Blurbs are one line from each registry record; every project keeps its own licence.
Every source this page cites, grouped by who published it. Grouping is read from the web address, not assigned by hand.
A source that has moved or gone is reported by the weekly link check. /audit/