Colorectal cancer screening with odour material by canine scent detection

Objective Early detection and early treatment are of vital importance to the successful treatment of various cancers. The development of a novel screening method that is as economical and non-invasive as the faecal occult blood test (FOBT) for early detection of colorectal cancer (CRC) is needed. A study was undertaken using canine scent detection to determine whether odour material can become an effective tool in CRC screening. Design Exhaled breath and watery stool samples were obtained from patients with CRC and from healthy controls prior to colonoscopy. Each test group consisted of one sample from a patient with CRC and four control samples from volunteers without cancer. These five samples were randomly and separately placed into five boxes. A Labrador retriever specially trained in scent detection of cancer and a handler cooperated in the tests. The dog first smelled a standard breath sample from a patient with CRC, then smelled each sample station and sat down in front of the station in which a cancer scent was detected. Results 33 and 37 groups of breath and watery stool samples, respectively, were tested. Among patients with CRC and controls, the sensitivity of canine scent detection of breath samples compared with conventional diagnosis by colonoscopy was 0.91 and the specificity was 0.99. The sensitivity of canine scent detection of stool samples was 0.97 and the specificity was 0.99. The accuracy of canine scent detection was high even for early cancer. Canine scent detection was not confounded by current smoking, benign colorectal disease or inflammatory disease. Conclusions This study shows that a specific cancer scent does indeed exist and that cancer-specific chemical compounds may be circulating throughout the body. These odour materials may become effective tools in CRC screening. In the future, studies designed to identify cancer-specific volatile organic compounds will be important for the development of new methods for early detection of CRC.

[1]  H. Wieand,et al.  Accuracy of fecal occult blood screening for colorectal neoplasia. A prospective study using Hemoccult and HemoQuant tests. , 1993, JAMA.

[2]  J. Wagner,et al.  Cost effectiveness of colorectal cancer screening in the elderly. , 1991, Annals of internal medicine.

[3]  Screening for colorectal cancer: recommendation and rationale. , 2002, American family physician.

[4]  Sang Min Park,et al.  Feasible economic strategies to improve screening compliance for colorectal cancer in Korea. , 2005, World journal of gastroenterology.

[5]  György Horvath,et al.  Human Ovarian Carcinomas Detected by Specific Odor , 2008, Integrative cancer therapies.

[6]  T. Ruers,et al.  Cost effectiveness of a new strategy to identify HNPCC patients , 2004, Gut.

[7]  H. Lynch,et al.  Diagnosis and management of hereditary colorectal cancer syndromes: Lynch syndrome as a model , 2009, Canadian Medical Association Journal.

[8]  G. Bassotti,et al.  Breath alkanes determination in ulcerative colitis and Crohn's disease , 1999, Diseases of the colon and rectum.

[9]  T. Peters,et al.  Clinical features of colorectal cancer before diagnosis: a population-based case–control study , 2005, British Journal of Cancer.

[10]  H T Lynch,et al.  Hereditary colorectal cancer. , 1991, Seminars in oncology.

[11]  H. Glick,et al.  Cost-effectiveness Analysis of Strategies for Colorectal Cancer Screening in Japan , 1994, International Journal of Technology Assessment in Health Care.

[12]  U. P. S. T. Force,et al.  Screening for Colorectal Cancer: Recommendation and Rationale , 2002, Annals of Internal Medicine.

[13]  Olaf Tietje,et al.  Prediction of breast cancer using volatile biomarkers in the breath , 2006, Breast Cancer Research and Treatment.

[14]  HywelC. Williams,et al.  Another sniffer dog for the clinic? , 2001, The Lancet.

[15]  L M Schuman,et al.  The effect of fecal occult-blood screening on the incidence of colorectal cancer. , 2000, The New England journal of medicine.

[16]  M. Phillips,et al.  Volatile Markers of Breast Cancer in the Breath , 2003, The breast journal.

[17]  S. Ramsey.  Screening for the Lynch syndrome. , 2005, The New England journal of medicine.

[18]  C. Willis,et al.  Olfactory detection of human bladder cancer by dogs: proof of principle study , 2004, BMJ : British Medical Journal.

[19]  Robert H Fletcher,et al.  Guidelines for Colonoscopy Surveillance after Polypectomy: A Consensus Update by the US Multi‐Society Task Force on Colorectal Cancer and the American Cancer Society * , † , 2006, Gastroenterology.

[20]  D R Brown,et al.  Breath hydrogen excretion as a screening test for the early diagnosis of necrotizing enterocolitis. , 1989, American journal of diseases of children.

[21]  HywelC. Williams,et al.  SNIFFER DOGS IN THE MELANOMA CLINIC? , 1989, The Lancet.

[22]  J. Terdiman,et al.  Colorectal cancer screening: clinical applications. , 2003, JAMA.

[23]  Uk Colorectal.  Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom , 2004, BMJ : British Medical Journal.

[24]  B. Stewart,et al.  World Cancer Report , 2003 .

[25]  A. Sonnenberg,et al.  Cost-Effectiveness of Colonoscopy in Screening for Colorectal Cancer , 2000, Annals of Internal Medicine.

[26]  Il-Jin Kim,et al.  [Hereditary colorectal cancer]. , 2005, The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi.

[27]  H. J. O’neill,et al.  A computerized classification technique for screening for the presence of breath biomarkers in lung cancer. , 1988, Clinical chemistry.

[28]  M. Phillips,et al.  Method for the collection and analysis of volatile compounds in the breath. , 1991, Journal of chromatography.

[29]  Robert H Fletcher,et al.  Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. , 2006, CA: a cancer journal for clinicians.

[30]  M. Mcculloch,et al.  Diagnostic Accuracy of Canine Scent Detection in Early- and Late-Stage Lung and Breast Cancers , 2006, Integrative cancer therapies.

[31]  I. Forgacs,et al.  Use of surrogate markers of inflammation and Rome criteria to distinguish organic from nonorganic intestinal disease. , 2002, Gastroenterology.

[32]  M. Phillips,et al.  Breath tests in medicine. , 1992, Scientific American.

[33]  J. Wilson,et al.  Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer , 2008, Gut.

[34]  Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology , 2000 .

[35]  M. Phillips,et al.  Increased pentane and carbon disulfide in the breath of patients with schizophrenia. , 1993, Journal of clinical pathology.

[36]  A. Sonnenberg,et al.  Colorectal cancer prevention 2000: screening recommendations of the American College of Gastroenterology , 2000, American Journal of Gastroenterology.

[37]  P. Boyle,et al.  World Cancer Report 2008 , 2009 .

[38]  H. J. O’neill,et al.  Volatile organic compounds in exhaled air from patients with lung cancer. , 1985, Clinical chemistry.

[39]  G. Davidson,et al.  A novel breath test for the Non‐invasive assessment of small intestinal mucosal injury following methotrexate administration in the rat , 2004, Scandinavian journal of gastroenterology.

[40]  R. Steele,et al.  Results of the first round of a demonstration pilot of screening for colorectal cancer in the United Kingdom , 2004, BMJ : British Medical Journal.

[41]  Hermann Brenner,et al.  Cost-effectiveness of colonoscopy in screening for colorectal cancer. , 2002, Archives of internal medicine.

[42]  Graham A. Colditz,et al.  Cost-effectiveness of screening for colorectal cancer in the general population. , 2000, JAMA.

[43]  J. Bretagne,et al.  Colonoscopy results of a French regional FOBT-based colorectal cancer screening program with high compliance , 2008, Endoscopy.

[44]  G. Preti,et al.  Analysis of lung air from patients with bronchogenic carcinoma and controls using gas chromatography-mass spectrometry. , 1988, Journal of chromatography.

[45]  Bernadette Mazurek Melnyk,et al.  Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. , 2008, Annals of internal medicine.