[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-348987-105":59,"doc-detail-348987-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","preclinical-circulating-tumor-dna-shedding-duration-and-prognostic-implications-of-modeling-3669-patients-with-cancer-original-article-abstract-and-results","Preclinical circulating tumor DNA shedding duration and prognostic implications of modeling 3669 patients with cancer - ORIGINAL ARTICLE - Abstract and results","","Preclinical circulating tumor DNA (ctDNA) detectability window and its prognostic implications are quantified using Bayesian modeling of detection rates and survival effects. Data come from 3669 cancer patients drawn from two biobank studies: CPS-3 with cancer diagnosed within 3 years after a prior blood draw and CCGA3 with a blood draw concurrent with diagnosis. Median preclinical sojourn times vary by stage and cancer type. ctDNA positivity at diagnosis is associated with increased mortality risk, informing design of multicancer early detection screening studies.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/preclinical-circulating-tumor-dna-shedding-duration-and-prognostic-implications-of-modeling-3669-patients-with-cancer-original-article-abstract-and-results/348987/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/preclinical-circulating-tumor-dna-shedding-duration-and-prognostic-implications-of-modeling-3669-patients-with-cancer-original-article-abstract-and-results/348987.png","ImageObject",300,407,{"name":92,"@type":93},"Aria Callaghan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-25","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How was preclinical ctDNA detectability modeled in this study?","Question",{"text":112,"@type":113},"The duration of preclinical detectability and its prognostic value were estimated using Bayesian models that describe detection rates as a function of time and infer prognostic effects.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which study cohorts were used to estimate sojourn time?",{"text":117,"@type":113},"The analysis used cancer patients from two biobank studies: ACS Cancer Prevention Study-3 (CPS-3) and Circulating Cell-Free Genome Atlas Substudy 3 (CCGA3).",{"name":119,"@type":110,"acceptedAnswer":120},"What did the results show about ctDNA sojourn time and prognosis?",{"text":121,"@type":113},"Median sojourn times differed by cancer stage and cancer type, and ctDNA positivity at clinical diagnosis versus negative was linked to higher mortality risk in CPS-3 cases.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},348987,1790323527,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},962084926284,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","DOI: 10. 1002/cncr.70380  \nORIGINAL ARTICLE  \nPreclinical circulating tumor DNA shedding duration and prognostic implications of modeling 3669 patients with cancer in the American Cancer Society Cancer Prevention Study-3 and Circulating Cell-Free Genome Atlas Substudy 3  \nEarl Hubbell PhD 1 | Alpa V. Patel PhD2  | Christina A. Clarke PhD, MPH1 | Emily L. Deubler MSPH2 | Eric T. Fung MD, PhD1 | Rong Jiang PhD1 |  \nAllison W. Kurian MD, MSc3  | Cari Lichtman MPH, MS2 | Lauren R. Teras PhD2 | Oliver Venn PhD1 | Nan Zhang PhD1 | Charles Swanton MBPhD4  \n1GRAIL, Inc., Menlo Park, California, USA 2Department of Population Science, American Cancer Society, Atlanta, Georgia, USA 3Division of Oncology, Department of Medicine, and Department of Epidemiology & Population Health, Stanford School of Medicine, Stanford, California, USA  \n4Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK  \nCorrespondence  \nEarl Hubbell, 1525 O'Brien Dr, Menlo Park, CA 94025.  \nEmail: [ehubbell@grailbio.com](ehubbell@grailbio.com)  \nFunding information  \nGrail, Inc.  \nAbstract  \nIntroduction: Previous studies have estimated the mean sojourn and dwell times within stages for commonly screened cancer types. However, little is known about the preclinical detection window of circulating tumor DNA (ctDNA) (ie, ctDNA positivity), which is important for understanding multicancer early detection. Methods: The duration of preclinical detectability and prognostic value of ctDNA detection was estimated from patients with cancer in two biobank studies: CPS-3, where cancer was diagnosed (n = 1064) within 3 years of a prior blood draw (2006–2013), and CCGA3 (NCT02889978), with a blood draw (2016–2019) concurrent with clinical diagnosis (n = 2604). To infer these quantities, Bayesian models were used for detection rates as a function of time, as well as to infer prognostic effects.  \nResults: Median [credible interval] sojourn times were 0.75 [0.47, 1. 30], 0.89 [0.61, 1. 33], 1.2 [0.84, 1. 67] years for cancers diagnosed at local, regional, and distant stage, respectively, and ranged by type from pancreas, 0.49 [0.26, 0.88] to lymphoma, 2.45 [1. 14, 4.87]. The extrapolated effect of ctDNA positivity at clinical diagnosis versus negative in CPS-3 cancer cases was a relative hazard ratio of 1.98 [1.08-4. 22] for mortality.  \nConclusions: These results provide estimates for average ctDNA detectable sojourn time in tumors across multiple cancer sites and stages and can inform the design of future screening studies for multicancer early detection.  \nKEYWORDS  \ncirculating tumor DNA (ctDNA), multicancer early detection (MCED), cancer screening, preclinical, sojourn time  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.  \n© 2026 The Author(s). Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.  \nINTRODUCTION  \nCancer is a progressive disease withoutcomes that worsen if diagnosed at later stages. The potential to detect cancer earlier, in the preclinical phase of development before symptoms occur, is enabled by recent advances in the measurement of circulating tumor DNA (ctDNA) shed by cancers into the blood. However, the shedding dynamics of ctDNA before clinical diagnosis are not known for most cancers. The presence of detectable quantities of ctDNA has previously been associated with relatively aggressive cancers,1–3 suggesting that these tumors may develop rapidly before clinical diagnosis. Understanding the duration (sojourn time) of the preclinical detection window before clinical diagnosis, either by symptomatic presentation or other means, in which early detection can occur (Figure 1), will help quantify the opportunity for early detection and inform screening interval.  ","cbCaivVXMv7L1uR9","https://ap.wps.com/l/cbCaivVXMv7L1uR9","pdf",437972,"English","# Introduction\n## Materials and Methods\n## Results\n## Conclusions","[{\"question\":\"How was preclinical ctDNA detectability modeled in this study?\",\"answer\":\"The duration of preclinical detectability and its prognostic value were estimated using Bayesian models that describe detection rates as a function of time and infer prognostic effects.\"},{\"question\":\"Which study cohorts were used to estimate sojourn time?\",\"answer\":\"The analysis used cancer patients from two biobank studies: ACS Cancer Prevention Study-3 (CPS-3) and Circulating Cell-Free Genome Atlas Substudy 3 (CCGA3).\"},{\"question\":\"What did the results show about ctDNA sojourn time and prognosis?\",\"answer\":\"Median sojourn times differed by cancer stage and cancer type, and ctDNA positivity at clinical diagnosis versus negative was linked to higher mortality risk in CPS-3 cases.\"}]","Preclinical circulating tumor DNA shedding duration and prognostic implications of modeling 3669 patients with cancer - ORIGINAL ARTICLE - Abstract and results | PDF",1790081035,25]