# Early detection of multiple cancer types using multidimensional cell-free DNA fragmentomics

Source: https://onco.cc/key-papers/paper-bao-fragmentomics-nat-med-2025/  
OnCo record `paper-bao-fragmentomics-nat-med-2025` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Geneseeq's whole-genome fragment test found most cancers in a laboratory set, and about half, mostly early, in a first prospective group of 3,724 people without symptoms.

## Summary

Bao and colleagues (Nanjing Geneseeq Technology) evaluated a multi-cancer test using genetic and fragmentomic features from whole-genome sequencing of plasma cell-free DNA. In an internal validation cohort (3,021 with cancer, 3,370 without) and an independent cohort (677 with cancer, 687 without), the independent set gave 87.4% sensitivity, 97.8% specificity and 82.4% tissue-of-origin accuracy. Preliminary results from a prospective study of 3,724 asymptomatic participants showed 53.5% sensitivity, predominantly for early-stage cancers, and 98.1% specificity.

## Fields

- Kind: Key paper
- Last checked: 2026-10-29
- Journal: Nature Medicine
- Year: 2025
- DOI: 10.1038/s41591-025-03735-2
- Authors: Bao H, Yang S, Chen X, et al.
- Findings: Independent validation: 87.4% sensitivity, 97.8% specificity, 82.4% tissue of origin.; Prospective asymptomatic cohort (3,724): 53.5% sensitivity, 98.1% specificity.
- What it means: The drop from 87% in known cancers to 54% in people without symptoms is the usual gap between case-control and screening performance, shown in one paper.
- Caveats: Prospective results are preliminary.; The abstract does not name a commercial product.

## Sources

- Nature Medicine 2025: https://doi.org/10.1038/s41591-025-03735-2
- PubMed: https://pubmed.ncbi.nlm.nih.gov/40425843/

## Connected records

- fronts: [Early Detection & Screening](https://onco.cc/fronts/early-detection/)
- technologies: [cfDNA fragmentomics](https://onco.cc/technologies/fragmentomics/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/)
- journals: [Nature Medicine](https://onco.cc/journals/nature-medicine/)

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