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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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WRAP-colorectal-cancer-adenoma-screening-using-urinary-volatile-organic compound-(VOC)-detection-Arasaradnam-2019.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (849Kb) | Preview |
Official URL: http://dx.doi.org/10.1007/s10151-019-01963-6
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 | ||||||||
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| 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 |
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| 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: |
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| 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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