Natera Review – Can ctDNA detection help doctors better diagnose and treat?

Natera Review Summary

Natera is a cell free DNA testing company that provides diagnosis for hereditary cancer and chromosomal abnormalities. Learn more in our Natera review!

Fiyin Ebemidayo



Natera helps customers diagnose DNA related disorders such as cancer types and prenatal chromosomal abnormalities. The tests are ordered by physicians and usually covered by insurance. However, customers have reported issues with contacting the company if there is a question with billing.


This review is written with the intent to be as unbiased as possible. However, it represents the opinion of an individual reviewer and is therefore subjective. Furthermore, at Nebula Genomics we seek to educate the public about the benefits of Whole Genome Sequencing. Information about our Whole Genome Sequencing DNA test is therefore incorporated into the review.

October 25, 2021

7 Facts from our CENTOGENE Review

  1. Location: San Carlos, California
  2. Products: Women’s health, oncology and organ health via cell-free DNA tests. 
  3. Cost: Varies by test. Not available online.
  4. Reports: Reports on your testing arrive after a few weeks. Your wait period depends on the type of testing
  5. How it works: Your physician orders the test and the testing kit is sent to you
  6. Raw Data Access: The results of tests are sent to your physician’s office 
  7. Other types of genetic testing: Nebula 30x Whole Genome Sequencing is a genetic test that decodes 100% of your genome. If you’re interested in your health and how it can be affected by genetic predispositions, this test is for you!

Natera Introduction

Natera is a global leader in cell-free DNA (cfDNA) testing company that seeks to bring improvement to the fields of women’s health, organ health, and the treatment of cancer. The company mission is to use cfDNA testing to provide better management of various diseases, including hereditary cancer and chromosomal abnormalities. 

Circulating tumor DNA
Circulating tumor DNA can be monitored in the bloodstream after surgery. Jonathan Bailey, NHGRI. Flickr.

Natera was founded in 2004 by Matthew Rabinowitz and Jonathan Sheena and was initially named the Gene Security Network. Matthew had just witnessed his sister lose her son to Down Syndrome a few days after his birth and this drove him to seek out methods that would help families diagnose hereditary conditions early. He continues to serve as upper management with the company. 

Natera’s main headquarters are in Austin, Texas with another branch located in San Antonio, California. Natera’s reach however spans more than 90 countries with more than 3 million tests done worldwide. 

Since its founding, Natera has carried out various research and unveiled several groundbreaking innovations to improve the standard of healthcare all over the world. Natera also makes its research available to laboratories through a platform dubbed Constellation.

Natera Review

The company sells products in 3 different health categories: Oncology, organ health, and women’s health.

Review of Natera oncology products

Signatera – Residual disease test (RDT)

The Signatera test is for people who have undergone surgery for cancer and want to check for residues, lingering cancer cells after attempts to remove the cancer. This test is important for the management of cancer as it enables one to detect molecular residual diseases as early as possible. This test checks for the presence of circulating tumor DNA (ctDNA) which can be used to detect if residues of cancerous cells are present in an individual after surgery. This test can be carried out immediately after treatment for cancer is completed to confirm if adjuvant therapy will be needed to prevent secondary tumor formation. The Signatera test is tailored to each patient’s genetic signature which allows for closer monitoring of the disease. The Signatera test has been found to be more than 85% accurate for predicting the relapse of cancer. 

ctDNA testing with the Signatera product from Natera.
ctDNA testing with the Signatera product from Natera.

Altera – Tumor Genomic profile

The Altera test is one for tumor profiling. Altera makes use of a Comprehensive Genome Profiling to test for the presence of more than 400 genes which are linked with the risk of cancer. The Altera test also incorporates the Signatera test to check for residue of cancerous cells. This test gives a report that includes FDA approved treatments for a patient’s specific condition as well as unconventional methods when all else fails. The Altera test allows you to carry out two tests using just one tumor sample through its tissue preservation service. This test helps to determine an approach to therapy for cancer patients. 

Empower – Hereditary cancer test

The Empower test is for hereditary cancer. This test is useful for assessing one’s risk of developing cancer. It can also help determine reasons for the frequency of cancer in a family as well as treatment options for cancer patients. 

Mutations in certain genes greatly increase the chances of developing cancer and the Empower test checks for up to 53 of these genes. This test helps an individual discover cancer early by influencing early screening, which increases the odds of treatment being successful. It also helps to recommend treatment options that will provide the best benefits with limited risk to the patient. Additionally, the Empower test can alert family members of individuals with hereditary cancer of the risk of cancer in their lineage, allowing them to make lifestyle decisions and screening plans to help prevent and monitor the development of cancer. 

Interested in genetic testing for hereditary cancer? You may be interested in these posts:

Review of Natera organ health products

Prospera Kidney – Transplant assessmentThe Prospera Kidney Transplant Assessment test can confirm the compatibility of a transplanted kidney from a single blood sample. Prospera uses advanced DNA techniques to ensure a donated kidney is compatible with the patient to prevent transplant rejection. A Prospera test is more accurate than a conventional serum creatinine test. The Prospera kidney transplant assessment test was developed after studies showed that more than 20% of kidneys transplanted fail in the first 5 years with more than 50% failing within 10 years. This test is covered by Medicare.

Serum Creatine vs Prospera
Serum Creatine vs Prospera

Prospera Heart – Transplant assessment

The Prospera Heart Transplant Assessment test is similar to the test for kidney compatibility except that it focuses on heart transplant compatibility. This test provides a non-invasive method to check for the compatibility of a donated heart with a patient. Studies have shown that a quarter of heart transplant patients experience complications within a year of their surgeries. This test is less costly and more convenient to perform than conventional biopsies while retaining a high level of accuracy which makes it a viable alternative to the conventional methods. 

Organ transplant
Genetic tests can help ensure the success of complex organ transplants. CMSRC. Flickr.

Renasight – Kidney gene panel

The Renasight test helps pinpoint if the root cause of a kidney disease is genetic. This test helps answer questions about the cause of one’s kidney disease and if kidney diseases run in your family. It also helps one manage kidney disease by predicting the progression of the disease. The results of the Renasight test assists physicians in drawing up a treatment plan tailored to a patient’s specific conditions. The test also alerts family members of patients with hereditary kidney diseases to their risk of developing kidney problems. The Renasight genetic test makes use of genetic testing to investigate more than 380 genes responsible for chronic kidney problems. The test kit can be ordered and returned with either blood or saliva samples. The results of the Renasight test are returned after about 3 weeks after the sample is submitted.

Review of Natera women’s health products

Horizon – Advanced carrier screening

The Horizon screening test is for parents that want to know if their children are at risk of inheriting certain genetic diseases. This test can be performed during pregnancy although it is advised that it be done before conception. As carriers are often not affected by the diseases they carry, the Horizon tests can confirm if the parents may pass any unknown diseases to their children. The Horizon test has the ability to reveal over 270 genetic conditions that can be passed from parent to offspring. Natera has a team of genetic counselors available to provide more information on the test and the results of the test. 

Panorama – non-invasive prenatal testing (NIPT)

Panorama provides a precise non-invasive test for pregnant women. The Panorama test makes use of technology based on single nucleotide morphisms (SNPs) to carry out tests for chromosomal conditions on the baby. The technology adopted for this test is able to tell the DNA of the mother apart from that of the baby she is carrying. 

The Panorama test is trusted by millions of mothers worldwide due to the fact that there is no risk of causing any harm to the baby as opposed to tests like chorionic villus sampling. This test can be used to test for conditions caused by absent or extra chromosomes. It can also be used to determine the sex of the child. The Panorama test is the only non-invasive prenatal test that can be used to test for triploidy. It can also be used to test for trisomies (such as trisomy 21 which causes down syndrome), sex chromosome abnormalities, and microdeletions. 

Panorama test kit from Natera
Panorama test kit

Vistara – Single gene NIPT

The Vistera genetic test for pregnant mothers helps determine serious genetic conditions that may otherwise be difficult to detect. The test checks for 25 of the most serious single gene genetic conditions that may be able to be managed if they are detected early. The Vistara test, just like the other Natera tests, needs only a blood sample from the mother to be carried out. The results of this test are usually delivered in 2 or 3 weeks. 

Vistara test kit from Natera
Vistara test kit

Anora – Miscarrage test

The Anora miscarriage test is used to determine the cause of a miscarriage. The Anora testing is slightly different from other genetic tests carried out by Natera as it uses a tissue sample from the miscarriage rather than a blood or saliva sample. The Anora test can help women who suffer from miscarriages move on and try for another pregnancy by allaying some of their fears as regards the miscarriage. 

Some causes of miscarriage such as chromosomal abnormalities are unlikely to lead to a second miscarriage and the family can go on to conceive again without any fears. The Anora miscarriage test is not meant to test recent miscarriages only, it can be used to find out the reason for miscarriages that occurred a long time ago. The test can also determine if the problem arose from the egg or the sperm. This test can help you determine the odds of a miscarriage recurring. The test results get delivered in about 7 days. 

Taking a Natera Genetics Test

The Natera tests cannot be ordered directly by the patient. The order has to be made by a physician. Once the physician places the order for the test kit, it gets delivered to the patient who then provides the sample. The sample provided is usually blood or saliva. Some blood tests require blood drawn either through a phlebotomist that comes to your home or at a Nateria-approved lab.

Once Natera receives the sample and carries out the tests, the results are sent to the ordering physician who then reviews them before they are made available on the online portal for the patient to view. 

Review of Natera Cost

The prices of the Natera tests cannot be found online as it needs a physician to place the order. Natera tests are covered by most health insurance companies and you can decide if you want to pay upfront or submit it as a claim to your health insurance. Natera also offers discounted prices for patients who have financial difficulties. 

Review of Natera Reports

Results of Natera tests usually arrive between 1 and 3 weeks after the samples are submitted to the clinical laboratory depending on the test being carried out. These labs are CAP accredited and CLIA certified. The test results are detailed summaries of what is being tested and the risks involved.

Positive and negative sample reports for the Panorama non-invasive testing kits are shown below. While details are included, the ultimate result of high or low risk is clearly stated in the front of each report.

Low risk panorama report from Natera
Low risk panorama report
High risk for Trisomy 18 in a panorama report from Natera
High risk for Trisomy 18 in a panorama report

Review of Natera Privacy

You can request for your test results to be sent via a secure means of delivery of your choice. Your choice will be agreed with as long as it is within reasonable limits. Your test results are only shared with the professionals in charge of your treatment and you can even choose to keep information that does not relate directly to your treatment away from them. 

The company uses DNAnexus’s cloud based genomics platform to support data analysis, storage, and sharing for its genetic tests.

Customer service can be reached at 1-650-249-9090.

Natera in the News

Nateria has had success in published research that demonstrates the validating and prognostic value of their genetic testing. In October 2021, the company released a peer-reviewed study in stage III colorectal cancer patients that demonstrates the connection between ctDNA growth rate and patient survival as measured by the Signatera ctDNA test. This test could be a new treatment tool for physicians and patients with colorectal cancer. 

Natera has been in the middle of a number of lawsuits. The latest is with the competing company, Guardant Health. In May 2021, Guardant issued a complaint alleging that Natera is misleading healthcare providers about the performance of the Guardant Reveal™ test, the first blood-only liquid biopsy test for colorectal cancer. The complaint claims that Nateria has suggested the Guardant Health test is inaccurate and/or insensitive, and inferior to Signatera™. Both companies, Natera and Guardant Health, have reported on the lawsuit on their respective websites. 

Pros and Cons


  • It’s a good company that reveals a lot about genetic conditions
  • Helps patients diagnose conditions early
  • Tests are more convenient than similar conventional tests 


  • The test kit cannot be ordered by individuals
  • Billing department can be difficult to work with 
  • 331 complaints, mainly associated with things such as being billed for lab work, filed with the Better Business Bureau

Nebula Genomics

Nebula Genomics is one of the world’s leading at-home genetic testing companies. Unlike Natera, it is not a diagnostic test. However, the results are of the highest quality so that they can be used by physicians to help guide medical decisions. The company’s use of it’s 30x whole Genomic sequencing allows it to decode 100% of the DNA makes its tests some of the most comprehensive on the market. 

Nebula focuses on genetic predispositions, like the Natera Empower test for hereditary disease and the Renasight test for kidney disease. Because whole genome sequencing decodes the entire genome, any gene that increases your risk will be detected, instead of just certain ones known at the time of purchase. As more research is conducted and more genetic information discovered, Nebula Genomic gene exploration tools allow you to return to your genome at any time.

The Nebula Research Library is updated weekly with the latest scientific discoveries, providing you with personalized reports on the latest genetic information. 

Did you like our Natera review? You can read more reviews on our blog and check out our complete guide to the best DNA test kit and other home tests. You may be particularly interested in Decipher Biosciences, Foundation Medicine, and Tempus Labs, other companies that use tumor genomics to help guide treatment.

Several companies use DNA sequencing for diagnostics. Unlike Natera, these tests are designed to be conducted on healthy individuals to help assess whether they are at risk for certain conditions.


  • Ambry Genetics (risks of various disease types)
  • Color (risks of cancer, genetic forms of heart disease, and medication responses)
  • Fulgent Genetics (comprehensive diagnostic company)
  • GeneDx (wide variety of clinical genomic tests)
  • Oral DNA Labs (specialized diagnostic tool for oral health)
  • Parsley Health (holistic medicine and health plans)
  • Pathway Genomics (DNA tests for various health aspects, may be used in consultation with medical providers)

Includes carrier status:

  • Integrated Genetics (pre- and post-pregnancy tests)
  • Invitae (diagnostics, proactive health, and reproductive health)
  • Myriad Genetics (diagnostics, reproductive tests, and precision medicine tests)
  • Sema4 (oncology, women’s health, carrier screening, and hereditary cancer)
  • Veritas Genetics (disease risks and carrier screenings)

Mental health:

  • GeneSight (clinical genomic test for psychotropics)
  • Genomind (pharmacogenomic testing for mental health treatment)

Rare diseases:

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