Heather Grant

Abstract Cancer development and response to treatment are evolutionary processes1,2, but characterizing evolutionary dynamics at a clinically meaningful scale has remained challenging3. Here we develop a new methodology called EVOFLUx, based on natural DNA methylation barcodes fluctuating over time4, that quantitatively infers evolutionary dynamics using only a bulk tumour methylation profile as input.

Discussion CRC risk is chronically underdiagnosed and overdiagnosed in colitis patients, due to lack of a sufficiently accurate predictor of future risk. Here, we have found that the pattern and burden of somatic CNAs within LGD lesions, as measured by standard short-read shallow whole genome sequencing, very strongly predicts the future risk of CRC, with PPV and NPVs at 5 years above 90%.

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