Circulating tumor DNA (ctDNA) assays may detect micrometastatic disease, potentially leading to an underestimation of risk in stage one cancers.

“you can envision a test that mainly catches the patient with micrometastatic disease and actually we have hints that the the ctdna assays preferentially catch those patients because of the things we talked about the beginning with there being now you know lots of microscopic deposits spread throughout the body if you were to put those all into one place and add them up you would have many billions of cells therefore overall you have more circulating tumor dna but and you can detect it but you think there's stage one because that's all you can see on the scan”