Updates are available Correction dated 2026-03-10

Article History

Accepted: 6 February 2026

First Online: 23 February 2026

Change Date: 10 March 2026

Change Type: Correction

Change Details: A Correction to this paper has been published:

Change Details: https://doi.org/10.1038/s41571-026-01140-3

Competing interests

: J.Z. has acted as a consultant and/or adviser or speaker or received research funding from AstraZeneca, Beigene, Bicara, Bristol Myers Squibb, Catalyst, GenePlus, Helius, Hengrui, Innovent Biologics, Johnson & Johnson, Merck, Novartis, OrigMed, Oncohost, Roche, Summit, Takeda and Varian. T.P. has acted as a consultant for FutureHouse, Edison Scientific and Scale AI; and is listed as an inventor (alongside C.S.) on patents filed in the UK related to risk prediction and early detection of lung cancer that have been filed, but are currently unpublished and remain within the priority year. E.S. has acted as an advisory board member or consultant for AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Janssen and Regeneron; and works in an institution that received research funding from AstraZeneca and Delfi Diagnostics. T.U.M. has acted as an advisory and/or data safety monitoring board member for AbbVie, AN2 Therapeutics, Arcus, Arrowhead, Astellas, AstraZeneca, Avammune, DBV Technologies, EMD Serono, EvolveImmune, Fate, G1 Therapeutics, Geneos, Genentech, Glenmark, Merck, Natures Toolbox, NGMbio, Ono Pharmaceutical, Regeneron, Replimmune, Storm and Tubulis; has received research grants from Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Merck and Regeneron; and holds stock options in Natures Toolbox. J.V.H. reports honoraria from AstraZeneca, Boehringer Ingelheim, BMS, BrightPath Biotherapeutics, Catalyst, Eli Lilly, EMD Serono, Foundation Medicine,Genentech, GSK, Guardant Health, Hengrui Therapeutics, Janssen, Kairos Venture Investments, Leads Biolanbs, Mirati Therapeutics, Nexus Health Systems, Novartis, Pneuma Respiratory, Roche, Sanofi, Spectrum and Takeda. S.M.D. has been on the scientific advisory boards for EarlyDiagnostics and LungLife AI, Inc. P.-C.Y. has acted as a consultant and/or adviser or speaker or received research funding from ACT Genomics, AstraZeneca, Boehringer Ingelheim, CHO Pharma, DELTA Electronics, Eli Lilly, GSK, Merck, MSD, OBI Pharma, Onenessbio, Ono Pharmaceutical, Pfizer, and Roche. C.S. has received grants from AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Invitae (previously Archer Dx Inc.), Ono Pharmaceutical, Personalis, Pfizer and Roche–Ventana; is Chief Investigator and Steering Committee Chair for the AstraZeneca MeRmaiD 1 and 2 clinical trials; is Co-Chief Investigator of the NHS Galleri trial funded by GRAIL; has received consultant fees from Achilles Therapeutics, Bicycle Therapeutics, China Innovation Centre of Roche (formerly Roche Innovation Centre, Shanghai), Genentech, Medicxi, Metabomed and the Sarah Cannon Research Institute; is a scientific advisory board member for Achilles Therapeutics, Bicycle Therapeutics, GRAIL, Relay Therapeutics and Saga Diagnostics; has received honoraria from Amgen, AstraZeneca, Bristol Myers Squibb, GSKline, Illumina, MSD, Novartis, Pfizer and Roche–Ventana; has previously held stock options in Apogen Biotechnologies and GRAIL; currently has stock options in Achilles Therapeutics, Bicycle Therapeutics, Epic Bioscience and Relay Therapeutics; is co-founder of Achilles Therapeutics; is listed as an inventor in patent applications for methods to detect lung cancer (PCT/US2017/028013), targeting neoantigens (PCT/EP2016/059401), identifying patient response to immune-checkpoint blockade (PCT/EP2016/071471), methods for lung cancer detection (US20190106751A1), identifying patients with responses to cancer treatment (PCT/GB2018/051912), determining HLA loss of heterozygosity (PCT/GB2018/052004), predicting survival rates of patients with cancer (PCT/GB2020/050221), and methods and systems for tumour monitoring (PCT/EP2022/077987); is listed as an inventor on a European patent application (PCT/GB2017/053289) relating to assay technology to detect tumour recurrence that has been licensed to a commercial entity and under their terms of employment, and is due a revenue share of any revenue generated from such license(s). The other authors declare no competing interests.