Discriminating colorectal cancer via exhaled volatile organic compounds.

BACKGROUND

Colorectal cancer (CRC) is a major cause of cancer-related death worldwide, highlighting the pressing need for an effective early detection method. Tumor metabolism leads to the release of volatile organic compounds (VOCs) into exhaled breath, offering a promising opportunity for noninvasive screening. Nevertheless, the absence of a targeted test has hindered its clinical application.

AIM: This study sought to develop and validate a specific breath VOC signature for discriminating CRC from other gastrointestinal diseases.

DESIGN

A case-control study.

METHODS

This study enrolled 248 participants, including patients with CRC, pancreatic cancer, ulcerative colitis, and healthy controls. A rigorous methodology was employed to control key confounders, such as oral-derived compounds, sex, and medication. Diagnostic models based on the VOC panel were developed using machine learning and validated in independent cohorts featuring diverse gastrointestinal conditions.

RESULTS

The analysis identified a panel of exhaled VOCs that discriminated CRC from controls with an AUC of 0.834. The breath-based testing also effectively distinguished CRC from other gastrointestinal conditions, with AUCs of 0.765 against ulcerative colitis and 0.739 against pancreatic cancer. Notably, combining exhaled VOCs with serum biomarkers enhanced diagnostic performance, yielding an AUC of 0.881.

CONCLUSION

The distinctive exhaled biomarkers in CRC demonstrate the potential of the breath testing as a robust, noninvasive screening tool.