Breath testing as potential colorectal cancer screening tool

Haitham Amal, Marcis Leja*, Konrads Funka, Ieva Lasina, Roberts Skapars, Armands Sivins, Guntis Ancans, Ilze Kikuste, Aigars Vanags, Ivars Tolmanis, Arnis Kirsners, Limas Kupcinskas, Hossam Haick

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

127 Scopus citations


Although colorectal cancer (CRC) screening is included in organized programs of many countries worldwide, there is still a place for better screening tools. In this study, 418 breath samples were collected from 65 patients with CRC, 22 with advanced or nonadvanced adenomas, and 122 control cases. All patients, including the controls, had undergone colonoscopy. The samples were analysed with two different techniques. The first technique relied on gas chromatography coupled with mass spectrometry (GC-MS) for identification and quantification of volatile organic compounds (VOCs). The T-test was used to identify significant VOCs (p values<0.017). The second technique relied on sensor analysis with a pattern recognition method for building a breath pattern to identify different groups. Blind analysis or leave-one-out cross validation was conducted for validation. The GC-MS analysis revealed four significant VOCs that identified the tested groups; these were acetone and ethyl acetate (higher in CRC), ethanol and 4-methyl octane (lower in CRC). The sensor-analysis distinguished CRC from the control group with 85% sensitivity, 94% specificity and 91% accuracy. The performance of the sensors in identifying the advanced adenoma group from the non-advanced adenomas was 88% sensitivity, 100% specificity, and 94% accuracy. The performance of the sensors in identifying the advanced adenoma group was distinguished from the control group was 100% sensitivity, 88% specificity, and 94% accuracy. For summary, volatile marker testing by using sensor analysis is a promising noninvasive approach for CRC screening. What's new? A breath test could help diagnose colorectal cancer, according to this new report. Because a breath test is minimally invasive, it could inspire better compliance than colonoscopy. These authors tested volatile organic compounds in breath samples from colorectal cancer cases and controls, using two different methods of analysis. They successfully identified four compounds that accurately identified the cancer patients, establishing a distinctive "breath-print" for colorectal cancer, possibly leading the way to a cheap, effective, non-invasive screening tool.

Original languageAmerican English
Pages (from-to)229-236
Number of pages8
JournalInternational Journal of Cancer
Issue number1
StatePublished - 1 Jan 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 UICC.


  • breath
  • colorectal cancer
  • diagnosis
  • sensor
  • spectrometry


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