Clinician opinions of circulating tumor DNA (ctDNA) testing vary. These findings were published in The Oncologist.

ctDNA analysis is emerging as a powerful oncologic biomarker, with potential as an early detection test that could reduce the use of more invasive and expensive cancer surveillance strategies. To better understand healthcare providers’ views on the utility of ctDNA among patients with hereditary cancer syndrome (HCS), 35 healthcare professionals in Canada were interviewed about their perspectives.

Most participants (n=28) were women and nearly half (n=12) were genetic counselors.

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There was general enthusiasm for ctDNA. Participants described it as “transformative” and a “game-changer.”

However, the providers were divided on how ctDNA could be used to manage HCS.

Optimistic professionals thought ctDNA could have high clinical utility for cancers without effective screening strategies, whereas pessimistic providers were uncertain whether patients would be willing to choose ctDNA testing over established evaluations.

Those with an optimistic view thought ctDNA could stand-alone compared with the more skeptical view that ctDNA testing would only ever be supplementary to other tests.

All providers agreed that patients with HCS undergo frequent and invasive screening for cancer. Optimistic providers thought ctDNA could reduce the invasiveness at point-of-testing, but pessimistic professionals thought ctDNA would increase the invasiveness and that some patients would be deterred by the need for frequent blood draws.

This study was limited by the hypothetical situation of ctDNA testing and real-world experiences may differ.

The researchers concluded that healthcare professionals anticipate ctDNA testing to transform early cancer detection. However, differing perspectives indicate that guidelines are needed to support standardization and decision making.

Disclosure: Multiple authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Shickh S, Oldfield LE, Clausen M, et al. “Game changer”: health professionals’ views on the clinical utility of circulating tumor DNA testing in hereditary cancer syndrome management. Oncologist. Published online April 6, 2022. doi:10.1093/oncolo/oyac039