{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:03:34Z","timestamp":1779793414949,"version":"3.53.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Circulating tumor DNA (ctDNA) is a novel prognostic biomarker indicating minimal residual disease and high recurrence risk. In three randomised DYNAMIC trials, ctDNA was used to guide adjuvant chemotherapy (ACT) for early\u2010stage colorectal cancer. While clinical applications of ctDNA are being established, the psychosocial impact, particularly on fear of cancer recurrence (FCR), is less understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the psychosocial impact, especially FCR, of ctDNA\u2010informed ACT decisions among a subset of DYNAMIC trial participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative study using semi\u2010structured interviews was conducted with English\u2010speaking, recurrence\u2010free patients from the DYNAMIC trials, across ctDNA\u2010guided and standard\u2010care groups. Interviews were audio\u2010recorded, transcribed, and thematically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010eight patients participated (median age 64\u00a0years; 64% male; equal numbers with early\u2010stage colon and rectal cancer). Eight received a positive ctDNA result, 11 a negative result, and 9 were blinded to their result. Three themes emerged: (1) Limited Understanding of ctDNA Results: Many patients had poor recall or understanding of the test and its prognostic meaning. (2) Trust in Clinician\u2010Led Decision\u2010Making: Strong reliance on clinicians to interpret results and guide ACT decisions. (3) FCR \u2010 Episodic, Context dependent: Fear was intermittent, typically arising around scans, new symptoms, or others' diagnoses, and was not influenced by ctDNA knowledge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort, on average 5\u00a0years from trial entry, ctDNA\u2010informed ACT decisions did not increase FCR or cause long term psychosocial harm. As ctDNA testing enters routine practice, clear communication strategies will be essential to ensure patients understand results while maintaining trust in clinician\u2013patient decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70464","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T18:41:29Z","timestamp":1776451289000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How Survivors of Colorectal Cancer Experience ctDNA Testing and Fear of Recurrence"],"prefix":"10.1002","volume":"35","author":[{"given":"Sue\u2010Anne","family":"McLachlan","sequence":"first","affiliation":[{"name":"St Vincent's Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine St Vincent's Hospital University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Hall","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine St Vincent's Hospital University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2139-0100","authenticated-orcid":false,"given":"Anna","family":"Collins","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine St Vincent's Hospital University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-0645","authenticated-orcid":false,"given":"Jennifer","family":"Philip","sequence":"additional","affiliation":[{"name":"St Vincent's Hospital  Melbourne Victoria Australia"},{"name":"Department of Medicine St Vincent's Hospital University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Personalised Oncology Division Walter and Eliza Hall Institute  Parkville Australia"},{"name":"Western Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Tie","sequence":"additional","affiliation":[{"name":"Personalised Oncology Division Walter and Eliza Hall Institute  Parkville Australia"},{"name":"Peter MacCallum Cancer Centre  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Australian Insitute of Health and Welfare.Canadian Datasystems(November 2024). Accessed 2025 https:\/\/www.aihw.gov.au\/reports\/cancer\/cancer\u2010data\u2010in\u2010australia\/contents\/rankings."},{"key":"e_1_2_9_3_1","unstructured":"Australian Institute of Health and Welfare. \u201cNational Screening Program \u201d (September 2025) Accessed 2025 https:\/\/www.aihw.gov.au\/reports\/cancer\u2010screening\/nbcsp\u2010monitoring\u20102025\/contents\/about."},{"key":"e_1_2_9_4_1","unstructured":"Cancer Council Australia. \u201cClinical Practice Guidelines for the Prevention Early Detection and Management of Colorectal Cancer \u201d (June 2024) Accessed 2025 https:\/\/www.cancer.org.au\/clinical\u2010guidelines\/bowel\u2010cancer\/colorectal\u2010cancer."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.21.02538"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16142597"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33312"},{"key":"e_1_2_9_8_1","unstructured":"ANZCT Register \u201cAustralian New Zealand Clinical Trials Registry (ANZCTR) [Internet]\u201d (NHMRC Clinical Trials Centre University of Sydney (Australia) December 2020) accessed 2005 https:\/\/www.anzctr.org.au."},{"key":"e_1_2_9_9_1","unstructured":"ANZCT Register \u201cAustralian New Zealand Clinical Trials Registry (ANZCTR) [Internet]\u201d (NHMRC Clinical Trials Centre University of Sydney (Australia) May 2025) accessed 2005 https:\/\/www.anzctr.org.au."},{"key":"e_1_2_9_10_1","unstructured":"ANZCT Register \u201cAustralian New Zealand Clinical Trials Registry (ANZCTR) [Internet]\u201d (NHMRC Clinical Trials Centre University of Sydney (Australia) December 2021) accessed 2005 https:\/\/www.anzctr.org.au."},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2200075"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010013\u20100272\u2010z"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5921"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajco.13434"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15184590"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6193"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.05.520"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2017.72.8212"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40364\u2010025\u201000796\u2010w"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2025.43.16_suppl.11125"},{"key":"e_1_2_9_21_1","volume-title":"The Foundations of Social Research: Meaning and Perspective in the Research Process","author":"Crotty M.","year":"1998"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201013\u2010117"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/ncc.0000000000001020"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.70464","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pon.70464","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.70464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:21:07Z","timestamp":1779790867000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.70464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/pon.70464"],"URL":"https:\/\/doi.org\/10.1002\/pon.70464","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70464"}}