{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:41:30Z","timestamp":1784313690260,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2026,4,15]]},"abstract":"Abstract<\/jats:title>\n \n Introduction<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The duration of preclinical detectability and prognostic value of ctDNA detection was estimated from patients with cancer in two biobank studies: CPS\u20103, where cancer was diagnosed (\n n<\/jats:italic>\n \u00a0=\u00a01064) within 3 years of a prior blood draw (2006\u20132013), and CCGA3 (NCT02889978), with a blood draw (2016\u20132019) concurrent with clinical diagnosis (\n n<\/jats:italic>\n \u00a0=\u00a02604). To infer these quantities, Bayesian models were used for detection rates as a function of time, as well as to infer prognostic effects.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 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\u20103 cancer cases was a relative hazard ratio of 1.98 [1.08\u20104.22] for mortality.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/cncr.70380","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T08:43:17Z","timestamp":1775724197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Preclinical circulating tumor DNA shedding duration and prognostic implications of modeling 3669 patients with cancer in the American Cancer Society Cancer Prevention Study\u20103 and Circulating Cell\u2010Free Genome Atlas Substudy 3"],"prefix":"10.1002","volume":"132","author":[{"given":"Earl","family":"Hubbell","sequence":"first","affiliation":[{"name":"GRAIL, Inc. Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9997-1218","authenticated-orcid":false,"given":"Alpa V.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Population Science American Cancer Society Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina A.","family":"Clarke","sequence":"additional","affiliation":[{"name":"GRAIL, Inc. Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily L.","family":"Deubler","sequence":"additional","affiliation":[{"name":"Department of Population Science American Cancer Society Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric T.","family":"Fung","sequence":"additional","affiliation":[{"name":"GRAIL, Inc. Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Jiang","sequence":"additional","affiliation":[{"name":"GRAIL, Inc. Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6175-9470","authenticated-orcid":false,"given":"Allison W.","family":"Kurian","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Medicine, and Department of Epidemiology & Population Health Stanford School of Medicine Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cari","family":"Lichtman","sequence":"additional","affiliation":[{"name":"Department of Population Science American Cancer Society Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren R.","family":"Teras","sequence":"additional","affiliation":[{"name":"Department of Population Science American Cancer Society Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Venn","sequence":"additional","affiliation":[{"name":"GRAIL, Inc. Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[{"name":"GRAIL, Inc. Menlo Park California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Swanton","sequence":"additional","affiliation":[{"name":"Cancer Evolution and Genome Instability Laboratory The Francis Crick Institute London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010023\u201005776\u20104"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41419\u2010018\u20100934\u2010x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.ccr\u201021\u20100417"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6604973"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2016.08.021"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2010.10.010"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30561"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.05.806"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.02.011"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2023.41.16_suppl.3004"},{"key":"e_1_2_10_12_1","unstructured":"Surveillance Epidemiology and End Results (SEER) Program.*Stat Database: Incidence \u2010 SEER Research Data 18 Registries (excl AK) Nov 2020 Sub (2000\u20102018) \u2010 Linked To County Attributes \u2010 Time Dependent (1990\u20102018) Income\/Rurality 1969\u20102019 Counties National Cancer Institute DCCPS Surveillance Research Program released April 2021 based on the November 2020 submission. Crude incidence rate calculation by single year of age and sex 2000\u20102018.www.seer.cancer.gov"},{"key":"e_1_2_10_13_1","unstructured":"Summary Staging | SEER Training. Accessed December 21 2023.https:\/\/training.seer.cancer.gov\/staging\/systems\/summary\/"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.70382"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn120"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201020\u20101134"},{"key":"e_1_2_10_17_1","unstructured":"R Interface to Stan. Accessed April 27 2023.https:\/\/mc\u2010stan.org\/rstan\/"},{"key":"e_1_2_10_18_1","unstructured":"TerryM.Therneau. A package for survival analysis in R.https:\/\/CRAN.R\u2010project.org\/package=survival"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncimono\/1997.22.15"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1158\/1538\u20107445.AM2024\u20103895"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1258\/jms.2010.009060"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70380","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cncr.70380","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.70380","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:04:14Z","timestamp":1779527054000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.70380"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":20,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,4,15]]}},"alternative-id":["10.1002\/cncr.70380"],"URL":"https:\/\/doi.org\/10.1002\/cncr.70380","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]},"assertion":[{"value":"2025-10-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70380"}}