While the incidence of most cancers is now steadying or declining, oesophageal adenocarcinoma continues an upward trend in developed countries. With prevalent risk factors including chronic reflux and obesity, and a poor survival rate of <20% at 5 years, there is an urgent unmet need to improve the detection and prevention of this cancer. Current diagnosis by upper gastrointestinal endoscopy is invasive and costly, hence not suitable for screening. Our goal was to develop a liquid biopsy test for oesophageal adenocarcinoma screening using surrogate serum proteins. This presentation will outline our journey and learnings through multiple phases of biomarker discovery, validation and translation towards clinical diagnostic test.