Recent discoveries have suggested that the promising avenue of using circulating tumor DNA (ctDNA) levels in blood samples provides reasonable accuracy for cancer monitoring, with extremely low burden on the patient's side. It is known that the presence of ctDNA can result from various mechanisms leading to DNA release from cells, such as apoptosis, necrosis or active secretion. One key idea in recent cancer monitoring studies is that monitoring the dynamics of ctDNA levels might be sufficient for early multi-cancer detection. This interesting idea has been turned into commercial products, e.g. in the company named GRAIL. In the present work, we propose to explore the use of Signature theory for detecting aggressive cancer tumors based on the analysis of blood samples. Our approach combines tools from continuous time Markov modelling for the dynamics of ctDNA levels in the blood, with Signature theory for building efficient testing procedures. Signature theory is a topic of growing interest in the Machine Learning community (see Chevyrev2016 and Fermanian2021), which is now recognised as a powerful feature extraction tool for irregularly sampled signals. The method proposed in the present paper is shown to correctly address the challenging problem of overcoming the inherent data scarsity due to the extremely small number of blood samples per patient. The relevance of our approach is illustrated with extensive numerical experiments that confirm the efficiency of the proposed pipeline.