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Colorectal cancer and adenoma screening using urinary volatile organic compound (VOC) detection : early results from a single-centre bowel screening population (UK BCSP)

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Mozdiak, Ella, Wicaksono, Alfian, Covington, James A. and Arasaradnam, Ramesh P. (2019) Colorectal cancer and adenoma screening using urinary volatile organic compound (VOC) detection : early results from a single-centre bowel screening population (UK BCSP). Techniques in Coloproctology, 23 (4). pp. 343-351. doi:10.1007/s10151-019-01963-6

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Official URL: http://dx.doi.org/10.1007/s10151-019-01963-6

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Abstract

Background

The United Kingdom (UK) bowel cancer screening programme has reduced mortality from colorectal cancer (CRC), but poor uptake with stool-based tests and lack of specificity of faecal occult blood testing (FOBT), has prompted investigation for a more suitable screening test. The aim of this study was to investigate the feasibility of a urinary volatile organic compounds (VOC)-based screening tool for CRC.

Methods

The urine from FOBT-positive patients was analysed using field asymmetric ion mobility spectrometry (FAIMS) and gas chromatography coupled with ion mobility spectrometry (GC–IMS). Data were analysed using a machine learning algorithm to calculate the test accuracy for correct classification of CRC against adenomas and other gastrointestinal pathology.

Results

One hundred and sixty-three patients were enrolled in the study. Test accuracy was high for differentiating CRC from control: area under the curve (AUC) 0.98 (95% CI 0.93–1) and 0.82 (95% CI 0.67–0.97) using FAIMS and GC–IMS respectively. Correct classification of CRC from adenoma was high with AUC range 0.83–0.92 (95% CI 0.43–1.0). Classification of adenoma from control was poor with AUC range 0.54–0.61 (95% CI 0.47–0.75) using both analytical modalities.

Conclusions

CRC was correctly distinguished from adenomas or no bowel pathology using urinary VOC markers, within the bowel screening population. This pilot study demonstrates the potential of this method for CRC detection, with higher test uptake and superior sensitivity than FOBT. In addition, this is the first application of GC–IMS in CRC detection which has shown high test accuracy and usability.

Item Type: Journal Article
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences
Faculty of Science, Engineering and Medicine > Engineering > Engineering
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Colon (Anatomy) -- Cancer -- Treatment -- Great Britain , Colonoscopy
Journal or Publication Title: Techniques in Coloproctology
Publisher: Springer
ISSN: 1123-6337
Official Date: April 2019
Dates:
DateEvent
April 2019Published
15 April 2019Available
8 March 2019Accepted
Volume: 23
Number: 4
Page Range: pp. 343-351
DOI: 10.1007/s10151-019-01963-6
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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