1. Test Sensitivity: The sensitivity of a test refers to its ability to correctly identify those with the disease. Tests with lower sensitivity are more likely to produce false negative results. 2. Sample Quality: Poor quality or insufficient sample collection can lead to inaccurate test results. 3. Tumor Characteristics: Some tumors may be too small or located in areas difficult to sample, making them harder to detect. 4. Technical Errors: Mistakes during the handling, processing, or analysis of samples can also result in false negatives.