A simple breath test that measures the levels of five chemicals in a person’s breath could detect cancers of the stomach and oesophagus, a large-scale patient trial has shown.
Presenting the findings of the research at the European Cancer Congress 2017 in Amsterdam, Dr Sheraz Markar, an NIHR Clinical Trials Fellow from Imperial College London, said the only way to diagnose esophageal cancer or stomach cancer at present is with endoscopy – a method that is expensive, invasive and isn’t without its complication risks.
“A breath test could be used as a non-invasive, first-line test to reduce the number of unnecessary endoscopies. In the longer term this could also mean earlier diagnosis and treatment, and better survival,” Dr Markar said.
The clinical trial, which involved more than 300 patients from three different London hospitals, showed the breath test had an overall accuracy of 85% when used to diagnose cancer.
It works by analysing a ‘chemical signature’ in people’s breath, which contains different levels of specific chemicals if they have stomach or esophageal cancer compared to just upper gastrointestinal symptoms and no cancer.
Of the patients taking part in the trial, 163 had been diagnosed with stomach or esophageal cancer and 172 had showed no evidence of cancer when they underwent an endoscopy.
Researchers measured the levels of butyric, pentanoic and hexanoic acids, butanal, and decanal in the breath samples provided by the patients. They then measured said breath samples against the chemical signature that indicated cancer. Their results showed an overall accuracy level of 85%, with a sensitivity of 80% and a specificity of 81%.
This means that not only was the breath test good at picking up those who had cancer (sensitivity), it was also good at correctly identifying who did not have cancer (specificity).
Dr Markar said: “Because cancer cells are different to healthy ones, they produce a different mixture of chemicals. This study suggests that we may be able detect these differences and use a breath test to indicate which patients are likely to have cancer of the esophagus and stomach, and which do not. However, these findings must be validated in a larger sample of patients before the test could be used in the clinic.”
It’s thought the new method could be used to save thousands of lives per year, as well as negating the need for patients to undergo painful endoscopy exams.
A larger trial is now planned over the next three years, which will see the test used on patients who are being given an endoscopy for gastrointestinal symptoms, but not yet diagnosed with cancer. This will enable them to determine the test’s effectiveness when used on a group that is likely to contain only a small percentage of people with cancer.
The team is also working on breath tests for other types of cancer, such as those affecting the bowel and pancreas, which could be used as first-line tests in general practice surgeries.
Each year in the UK, around 6,682 people are diagnosed with stomach cancer and 4,576 die from the disease. There are 8,919 cases of oesophageal cancer, affecting the food pipe or gullet, with 7,790 deaths.
Cancer Research UK’s Dr Justine Alford welcomed the findings: “The next step is to see if it can detect the disease at its earliest stages.”
Anything that helps with earlier diagnosis, intervention, treatment and ultimately a better survival rate in the fight against Cancer has to be considered. The current overall accuracy of 85% when used to diagnose Cancer is a figure that means further research is vital to see if it can detect the disease at its earliest stages.
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