Attitudes of cancer patients toward ctDNA-based liquid biopsy for follow-up

Circulating tumor DNA-based liquid biopsy is increasingly integrated into cancer care, particularly for detecting minimal residual disease, yet patient perspectives remain poorly understood. This single-center, cross-sectional, mixed-methods study assessed recall, knowledge, and attitudes toward liquid biopsy and circulating tumor DNA among 195 patients (median age 65 years; 63% female) undergoing cancer treatment or follow-up, supplemented by focus groups. Although 65% reported prior liquid biopsy, this was confirmed in only 44%, and only 10% had heard of circulating tumor DNA (ctDNA). Correct recall and knowledge on ctDNA were higher among patients with neuroendocrine neoplasms and those with postgraduate education. In hypothetical scenarios assuming proven clinical validity and utility, 62-80% supported liquid biopsy-guided clinical action, 74% were comfortable with liquid biopsy replacing tissue biopsy, and 79% accepted its use to guide adjuvant treatment. Most patients anticipated reassurance rather than stress, and 85% expected improved quality of life with home- or general practitioner-based blood sampling. Overall, patients showed high acceptance of clinically actionable liquid biopsy use, driven by trust and perceived clinical benefit.