In Pipeline

Percepta Nasal Swab Test

Percepta Nasal Swab is a cutting-edge, evidence-based test designed to advance precision in lung cancer risk assessment. It uses a simple, non-invasive nasal brush and is more convenient than a blood draw.

Cancer area illustration

What is the Percepta Nasal Swab test?

Percepta Nasal Swab is a non-invasive molecular diagnostic for lung nodule assessment in patients with lung nodules and a smoking history.

Developed using whole-transcriptome sequencing and advanced machine learning, it leverages “field of injury” science, which can detect genomic changes linked to lung cancer that can be found in epithelial cells in the nasal passages of current and former smokers.1,2

Inherited Risk Assessment
Screening and Risk Assessment
Diagnosis
Prognosis
Treatment Guidance
Recurrence Monitoring

KEY CLINICAL EVIDENCE

Consistent performance across nodule sizes and patient populations.3

Low-Risk Patients

98%

Negative predictive value (NPV)

In a population with a 25% cancer prevalence, Percepta Nasal Swab has a 97% sensitivity in identifying low-risk patients. This can help clinicians and patients avoid unnecessary procedures.

High-Risk Nodules

70%

Positive predictive value (PPV)

In a population with a cancer prevalence of 25%, Percepta Nasal Swab has a 92% specificity in identifying high-risk patients. This can help direct clinicians to explore further procedures to obtain an accurate diagnosis. 

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Statistics

Clinical validation data: evidence-based genomic assessment of lung nodules

The Percepta Nasal Swab clinical validation study, published in the journal CHEST, demonstrates significant advances in objective lung nodule risk assessment. This peer-reviewed research validates the test’s capability to support clinical decision-making for patients with lung nodules identified through computed tomography (CT) screening.

Physicians need an objective, accurate tool to help guide care for patients when a lung nodule is found on a CT scan. Our findings demonstrate the Percepta Nasal Swab test’s ability to enhance lung nodule risk assessment, potentially reducing unnecessary diagnostic procedures for low-risk patients while supporting timely intervention for those at high risk.”

Photo of Bill Bulman
Bill Bulman, M.D. Medical Director for Pulmonology at Veracyte and study author

Explore clinical validation study and data

High sensitivity of a nasal genomic classifier for identifying malignant pulmonary nodules: a preliminary analysis

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Analytical validation of the Percepta Nasal Swab classifier; an RNA next-generation sequencing assay for the assessment of lung cancer risk in pulmonary nodules

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Learn how the NIGHTINGALE study is validating the Percepta Nasal Swab test's ability to improve lung nodule management.

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The lung cancer landscape

Statistics

Lung cancer is the leading cause of death worldwide, and it is well established that early detection and diagnosis can reduce mortality.

  • Approximately 15M people are eligible for annual screening in the US.4
  • 1.6M lung nodules are detected annually in the US.5
  • Only 18.2% of high-risk people in the US get screened for lung cancer.6

Lung nodules are an early indicator of lung cancer and are typically found using a CT scan.

Challenges

Traditionally, lung cancer screening rates have been low and there have been nodule risk assessment uncertainties.

  • 44% of low-risk patients undergo unnecessary invasive procedures7 and 50% of lung cancer patients experience delayed diagnosis due to multiple biopsies.8

The future of lung cancer risk assessment lies in objective, non-invasive genomic testing that can help improve risk assessment, reduce unnecessary procedures, and ensure patients get the right treatment at the right time.

Percepta Nasal Swab helps guide better decisions through an innovative approach

We aim to provide clinicians with a simple, non-invasive genomic test that transforms pulmonary nodule evaluation, so they can provide better care for their “at-risk” patients.

This test helps to:

  • Provide objective risk classification
  • Reduce unnecessary procedures
  • Support timely intervention of high-risk patients
  • Enable confident clinical decision-making

How Lung Cancer Assessment Works

A combination of powerful technologies

Nasal epithelial cells are collected using a soft cytology brush. Using the well-studied foundational field of injury principle, we can investigate gene expression changes in individuals with a history of smoking. These changes can provide insights into the risk of developing lung cancer in patients with pulmonary nodules.5,6

This process examines the complete genetic expression profile (RNA) of nasal epithelial cells, providing deeper insights into cellular changes associated with lung cancer development in patients with a smoking history – including those who currently smoke or have a history of smoking.

These algorithms deliver highly accurate risk assessment results by combining expression data with clinical factors to classify lung cancer risk in patients with pulmonary nodules and a history of smoking more than 100 cigarettes in their lifetime.3

How does the Percepta Nasal Swab test work?

1

Sample collection

  • Simple, in-office nasal brushing
  • Non-invasive sample collection

2

Advanced analysis

  • Whole-transcriptome sequencing
  • Machine learning classification
  • Novel genomic classifier

3

Test results

  1. Actionable results and evidence-based guidance
  2. Clear results for risk stratification
Percepta Nasal Swab test results

Low Risk:

Monitor with low dose CT.

percepta nasal swab test result low risk icon

Moderate Risk:

Consider non-surgical tissue sampling inclusive of bronchoscopy.

percept nasal swab test result moderate risk icon

High Risk:

Consider direct surgery and/or treatment.

percepta nasal swab test result high risk icon

Paving the way for Percepta

The next critical step for Percepta Nasal Swab is finalizing our clinical utility study, NIGHTINGALE, which will support reimbursement.


NIGHTINGALE is a landmark clinical utility study at hospitals and clinics around the United States to demonstrate the test’s ability to improve patient care and outcomes.

Explore NIGHTINGALE Study
Large-scale randomized trial
Diverse patient population
Comprehensive endpoint analysis
Focus on real-world clinical impact
NIGHTINGALE Study

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Clinical Studies

Studies demonstrating the impact of our tests across cancer types.

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Veracyte publications and references showcasing discoveries and advancements.

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References

  1. Silvestri GA, et al. A bronchial genomic classifier for the diagnostic evaluation of lung cancer. N Engl J Med. 2015;373(3):243-251. https://doi.org/10.1056/NEJMoa1504601
  2. Spira A, et al. Airway epithelial gene expression in the diagnostic evaluation of smokers with suspect lung cancer. Nat Med. 2007;13(3):361-366. https://doi.org/10.1038/nm1556
  3. Lamb CR, Rieger-Christ KM, Reddy C, et al. A nasal swab classifier to evaluate the probability of lung cancer in patients with pulmonary nodules. Chest. 2024;165(4):1009-1019. https://doi.org/10.1016/j.chest.2023.11.036
  4. NEJM Clinician. USPSTF Expands Lung Cancer Screening to Millions More. Published March 9, 2021. Accessed February 23, 2026. https://clinician.nejm.org/uspstf-expands-lung-cancer-screening-millions-nejm-jw.FW117596
  5. Gould MK, et al. Recent trends in the identification of incidental pulmonary nodules. Am J Respir Crit Care Med. 2015;192(10):1208-1214. https://doi.org/10.1164/rccm.201505-0990OC
  6. American Lung Association. State of Lung Cancer 2025 Report. American Lung Association; 2025. Accessed February 11, 2026. https://www.lung.org/getmedia/5f587b49-4f94-4fd0-8e57-c55de5e684b5/SOLC-2025-Print-Report.pdf
  7. Tanner NT, et al. Management of pulmonary nodules by community pulmonologists: a multicenter observational study. Chest. 2015;148(6):1405-1414. https://doi.org/10.1378/chest.15-0630
  8. Zhang Y, et al. Biopsy frequency and complications among lung cancer patients in the United States. Lung Cancer Manag. 2020;9(4):LMT40. https://doi.org/10.2217/lmt-2020-0022

Disclaimers

This webpage contains forward-looking statements. These forward-looking statements involve risks and uncertainties. For more information, read our forward-looking statement.

Talk to your doctor about whether Veracyte tests might be right for you.