Cheap DNA fragment-pattern blood test as a first sieve before expensive cancer tests

The way DNA fragments in blood are chopped up differs in cancer and can be read with cheap, shallow sequencing, so this idea uses cell-free DNA fragmentomics as a first sieve, with deep methylation testing reserved for the top tenth by risk. DELFI Diagnostics and Johns Hopkins have validated fragmentomics with low-coverage whole-genome sequencing and machine learning in high-risk lung cohorts. Cost per test rather than accuracy limits yearly population screening, and tiering is how HPV and cytology triage already works. The test re-analyses banked plasma from a prospective MCED cohort with both assays, then runs a prospective tiered pilot. At early-clinical maturity it addresses the bottleneck The hardest cancers are found late.