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Colorectal cancer screening using urinalysis

Urinary volatile organic compounds (VOCs)-based screening is a feasible option for colorectal cancer (CRC) in the UK and may address the current low uptake of stool-based screening, according to research from the University of Warwick and the University Hospitals Coventry and Warwickshire.

For the study, urine samples from 163 patients with a positive faecal occult blood testing (FOBT) results were analysed using field asymmetric ion mobility spectrometry (FAIMS) and gas chromatography coupled with ion mobility spectrometry (GC-IMS). Data were analysed using a machine learning algorithm to calculate the test accuracy for correct classification of CRC against adenomas and other gastrointestinal pathology.

Test accuracy was high for differentiating CRC from control: area under the curve (AUC) 0.98 (95% CI, 0.93-1.0) and 0.82 (95% CI, 0.67-0.97) using FAIMS and GC-IMS, respectively. Correct classification of CRC from adenoma was high, with AUC range 0.83-0.92 (95% CI, 0.43-1.0). Classification of adenoma from control was poor, with AUC range 0.54-0.61 (95% CI, 0.47-0.75) using both analytical modalities.

More than 90 per cent of patients invited to participate in the study were recruited, far exceeding the FOBT uptake rate of approximately 60 per cent.

The authors say the findings of the pilot study demonstrate the potential of this method for CRC detection, with higher test uptake and superior sensitivity than FOBT.


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