Breath based volatile organic compounds in the detection of breast, lung, and colorectal cancers: A systematic review

Abstract

Background: Detecting volatile organic compounds (VOCs) could provide a rapid, noninvasive, and inexpensive screening tool for detecting cancer.

Objective: In this systematic review, we identified specific exhaled breath VOCs correlated with lung, colorectal, and breast cancer.

Methods: We identified relevant studies published in 2015 and 2016 by searching Pubmed and Web of Science. The protocol for this systematic review was registered in PROSPERO and the PRISMA guidelines were used in reporting. VOCs and performance data were extracted.

Results: Three hundred and thirty three records were identified and 43 papers were included in the review, of which 20 were review articles themselves. We identified 17 studies that listed the VOCs with at least a subset of statistics on detection cutoff levels, sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and gradient.

Conclusions: Breath analysis for cancer screening and early detection shows promise, because samples can be collected easily, safely, and frequently. While gas chromatography-mass spectrometry is considered the gold standard for identifying specific VOCs, breath analysis has moved into analyzing patterns of VOCs using a variety of different multiple sensor techniques, such as eNoses and nanomaterials. Further development of VOCs for early cancer detection requires clinical trials with standardized breath sampling methods.

Keywords: Exhaled breath; biomarkers; breast cancer; colorectal cancer; lung cancer; volatile organic compounds (VOCs).