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• W3211684586 abstract "<h3>Introduction</h3> Colorectal cancer (CRC) is the 2nd commonest cause of cancer death in the UK, making up 11% of new cancer cases. Despite this, 5-year survival rates are 58%, amongst the lowest in Europe. There is need for improvement because CRC survival rates can exceed 90% if detected early. This study aimed to investigate the diagnostic accuracy of breath testing for CRC. If successful, a breath test could provide a highly acceptable non-invasive tool to improve and streamline existing referral CRC pathways. This could lead to earlier and more targeted diagnosis, ultimately saving both lives and resources. <h3>Method</h3> COBRA1 was a multicentre cohort study investigating volatile organic compounds (VOCs) in the breath of 1432 patients attending one of seven London hospitals for colonoscopy or for colorectal adenocarcinoma resection. Patient breath was collected using the ReCIVA breath sampler and thermal desorption tubes. Patients were nil by mouth for at least 6 hours and were sampled immediately prior to their procedure, in a separate area. All colorectal pathologies were diagnosed using the standard reference test (colonoscopy), with histological confirmation for CRC, polyps, or inflammatory bowel disease. Breath was analysed using gas chromatography mass spectrometry (GC-MS), and resulting VOC data processed using the GC-MS data platform MSHub. A machine learning algorithm was used to identify VOC components with the best discriminating ability and to develop a multivariate discriminant analysis model. VOCs were identified using the NIST mass spectral library. <h3>Results</h3> The presence of CRC (n=162) could be predicted from positive and negative controls (n=1270) with a sensitivity of 77%, specificity of 87% and an area under the ROC (AUROC) curve of 0.87. 15 of the most predictive VOCs were from organosulphur, alcohol, alkane, ester and phenol chemical groups. VOC abundances also appeared to be related to the T stage of the tumour. Polyps (n=592) could be predicted from positive and negative controls (n=619): sensitivity 66%, specificity 54%, AUROC curve of 0.65. Subgroup analysis of symptomatic patients (n=855), demonstrated a sensitivity of 82%, a specificity of 88% for CRC detection, with an AUROC curve of 0.90. <h3>Conclusions</h3> Analysis of exhaled VOCs could discriminate patients with CRC from those without, using the gold-standard diagnostic test and VOC analytical method. Results can be compared favourably to stool-based tests, particularly for polyps and symptomatic patients. These exciting findings pave the way for larger targeted VOC studies to validate results and explore implementation into clinical practice." @default.
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• W3211684586 date "2021-11-01" @default.
• W3211684586 modified "2023-09-26" @default.
• W3211684586 title "OFR-7 Breath testing for colorectal polyps and cancer- the colorectal breath analysis1 study (COBRA1)" @default.
• W3211684586 doi "https://doi.org/10.1136/gutjnl-2021-bsg.30" @default.
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