Single-cell phylodynamics reveal rapid late-stage colorectal cancer expansions

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Abstract

Single-cell whole-genome sequencing of 335 cells from seven colorectal cancers, coupled with Bayesian phylodynamic modeling, revealed tumors often originate decades before diagnosis, remain indolent, and expand rapidly within two years. Strong spatial structuring with minimal interregional mixing was observed, while substitution rates varied widely and were decoupled from growth. Our findings highlight extended evolutionary stasis and sudden expansion, informing strategies for early detection and intervention.

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