Title: | Colorectal cancer and adenoma screening using urinary volatile organic compound (VOC) detection: early results from a single-centre bowel screening population (UK BCSP) |
Author(s): | Mozdiak E; Wicaksono AN; Covington JA; Arasaradnam RP; |
Address: | "University Hospitals Coventry and Warwickshire, Coventry, UK. ella.mozdiak@nhs.net. School of Engineering, The University of Warwick, Coventry, UK. University Hospitals Coventry and Warwickshire, Coventry, UK" |
DOI: | 10.1007/s10151-019-01963-6 |
ISSN/ISBN: | 1128-045X (Electronic) 1123-6337 (Print) 1123-6337 (Linking) |
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" |
Keywords: | Adenoma/*diagnosis Aged Area Under Curve Colorectal Neoplasms/*diagnosis Early Detection of Cancer/*methods Female Humans Ion Mobility Spectrometry/methods/*statistics & numerical data Male Middle Aged Occult Blood Pilot Projects Predictive Value of Tests; |
Notes: | "MedlineMozdiak, E Wicaksono, A N Covington, J A Arasaradnam, R P eng Evaluation Study Italy 2019/04/17 Tech Coloproctol. 2019 Apr; 23(4):343-351. doi: 10.1007/s10151-019-01963-6. Epub 2019 Apr 15" |