Colorectal Cancer Clinical Trial
Official title:
The Effectiveness of Breath Analysis Versus FIT for Colorectal Cancer Screening
Endogenous breath VOCs (Volatile Organic Compounds) are present in various excreted
biological materials (urine, blood, faeces an breath) and their analysis offers a possibility
for cancer screening. Some of these VOCs are reversed in the venous blood stream and reach
the lung alveoli where some of them are exhaled.
Colorectal cancer (CRC) is one of the commonest tumours and is an important cause of
cancer-related mortality. Colonoscopy is the gold standard for the diagnosis of CRC.
Screening with fecal immunochemical test (FIT) is associated with a 13-18% CRC-mortality
reduction.
Aim of the study To compare the reliability of this breath analysis with
Immunochemically-based Fecal Occult Blood Test.
Volatile organic compounds (VOCs) are low molecular weight (<1 kDa) compounds which represent
the final products of cell metabolism. Their composition can be affected by several factors
including diet, hormones, environment and the presence of diseases, in particular, cancer.
Endogenous breath VOCs are present in various excreted biological materials (urine, blood,
faeces an breath) and their analysis offers a possibility for cancer screening. Some of these
VOCs are reversed in the venous blood stream and reach the lung alveoli where some of them
are exhaled.
Colorectal cancer (CRC) is one of the commonest tumours and is an important cause of
cancer-related mortality. Colonoscopy is the gold standard for the diagnosis of CRC, although
its cost prevents its use for mass screening. Furthermore colonoscopy is not well accepted by
patients since it is an invasive exam. Screening with fecal immunochemical test (FIT) is
associated with a 13-18% CRC-mortality reduction in major randomized studies and is the most
widely used non-invasive screening tool, showing fairly good specificity but a high variation
in sensitivity (61-91%) and adherence to screening programmes rarely reaches 50-70% of the
target population.
Recently the breath analysis has been demonstrated to be a new well accepted and non-invasive
tool to detect colorectal cancer.
The purpose of this trial is to compare the reliability of this breath analysis with
Immunochemically-based Fecal Occult Blood Test, which is the routinely employed tool for mass
screening. A group of subjects adherent to the regional screening program for colorectal
cancer prevention, who resulted positive to the FIT, will be enrolled in this study, and will
have a breath sampling before undergoing colonoscopy. The predictive ability of the Breath
test will be tested in a blind fashion in this selected group of high-risk subjects.
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