Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.


Towards multi-cancer screening using liquid biopsies

Cell-free DNA and proteins are secreted into the bloodstream by multiple types of cancer. In a recently published prospective study involving 10,006 women, such markers were used in a cancer screening approach that incorporated PET–CT as a confirmatory test. Herein, we discuss the implications of these results.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Protocol used in liquid biopsy-based cancer screening study4.


  1. Chiu, R. W. K. et al. Noninvasive prenatal diagnosis of fetal chromosomal aneuploidy by massively parallel genomic sequencing of DNA in maternal plasma. Proc. Natl Acad. Sci. USA 105, 20458–20463 (2008).

    Article  CAS  Google Scholar 

  2. Wan, J. C. M. et al. Liquid biopsies come of age: Towards implementation of circulating tumour DNA. Nat. Rev. Can. 17, 223–238 (2017).

    Article  CAS  Google Scholar 

  3. Chan, K. C. A. et al. Analysis of plasma Epstein–Barr virus DNA to screen for nasopharyngeal cancer. N. Engl. J. Med. 377, 513–522 (2017).

    Article  CAS  Google Scholar 

  4. Lennon, A. M. et al. Feasibility of blood testing combined with PET-CT to screen for cancer and guide intervention. Science (2020).

    Article  PubMed  Google Scholar 

  5. Cohen, J. D. et al. Detection and localization of surgically resectable cancers with a multi-analyte blood test. Science 359, 926–930 (2018).

    Article  CAS  Google Scholar 

  6. Lam, W. K. J. et al. Sequencing-based counting and size profiling of plasma Epstein–Barr virus DNA enhance population screening of nasopharyngeal carcinoma. Proc. Natl Acad. Sci. USA 115, E5115–E5124 (2018).

    Article  CAS  Google Scholar 

  7. Lam, W. K. J. et al. Methylation analysis of plasma DNA informs etiologies of Epstein-Barr virus-associated diseases. Nat. Commun. 10, 3256 (2019).

    Article  Google Scholar 

  8. Sun, K. et al. Plasma DNA tissue mapping by genome-wide methylation sequencing for noninvasive prenatal, cancer, and transplantation assessments. Proc. Natl Acad. Sci. USA 112, E5503–E5512 (2015).

    Article  CAS  Google Scholar 

  9. Liu, M. C. et al. Sensitive and specific multi-cancer detection and localization using methylation signatures in cell-free DNA. Ann. Oncol. 31, 745–759 (2020).

    Article  Google Scholar 

  10. Jiang, P. et al. Plasma DNA end motif profiling as a fragmentomic marker in cancer, pregnancy and transplantation. Cancer Discov. 10, 664–673 (2020).

    PubMed  Google Scholar 

Download references


The authors’ work is supported by the Hong Kong Research Grants Council Theme-Based Research Scheme (T12-401/16-W) and the Li Ka Shing Foundation.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Y. M. Dennis Lo.

Ethics declarations

Competing interests

Y.M.D.L. is a scientific co-founder, shareholder, scientific advisory board member and consultant of, and receives research support from, Grail. He is also a founder, shareholder and board member of the Take2 Group of companies and DRA Limited and an advisor of Decheng Capital. W.K.J.L. holds equity in Grail.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lo, Y.M.D., Lam, W.K.J. Towards multi-cancer screening using liquid biopsies. Nat Rev Clin Oncol 17, 525–526 (2020).

Download citation

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer