Research Communication: Breath Testing for Colorectal Cancer Detection in Patients With a Positive Fecal...

Area of Science:

• Gastroenterology
• Medical Technology
• Oncology

Background:

• Colorectal cancer (CRC) screening is crucial but current methods like fecal immunochemical tests (FIT) have limitations.
• Improving CRC detection rates and diagnostic accuracy remains a significant challenge in public health.

Purpose of the Study:

• To evaluate the diagnostic performance and reproducibility of an electronic nose (e-nose) for detecting colorectal cancer (CRC) in FIT-positive individuals.
• To assess the external validation and clinical readiness of e-nose technology for CRC screening.

Main Methods:

• A multicentre study involving 3469 participants, with 5.0% diagnosed with CRC.
• The electronic nose (e-nose) was tested for diagnostic accuracy (AUC, sensitivity, specificity) and reproducibility (ICC).
• Patient acceptability and willingness to repeat the test were also recorded.

Main Results:

• The e-nose demonstrated poor diagnostic performance with an AUC of 0.542, sensitivity of 39.5%, and specificity of 68.3%.
• Reproducibility was low, indicated by an intraclass correlation coefficient (ICC) of 0.22.
• Despite high patient acceptability (95.3% willingness-to-repeat), the e-nose did not meet clinical performance standards.

Conclusions:

• Current electronic nose (e-nose) technology is not sufficiently accurate or reproducible for clinical implementation in colorectal cancer (CRC) screening.
• Further research is essential to standardize and validate e-nose devices before they can supplement existing CRC screening strategies.
• While patient acceptance is high, the technology's diagnostic limitations necessitate caution regarding its immediate application in clinical settings.