Colorectal breath analysis (COBRA)
Research type
Research Study
Full title
Non-invasive testing for the diagnosis and assessment of colorectal disease
IRAS ID
223074
Contact name
George Hanna
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
5 years, 0 months, 0 days
Research summary
Colorectal cancer (CRC) is the 2nd commonest cause of cancer death in the UK. Survival rates are among the lowest in Europe yet if diagnosed early, exceed 90%. A breath test is a non-invasive investigation, detecting the presence of volatile organic compounds (VOCs) in breath and their alteration in colorectal cancer. The use of a breath test in Primary Care could identify high-risk patients who should be referred for colonoscopy at an earlier stage, increase the proportion of appropriate referrals, and improve NICE guidelines. It could also provide reassurance to patients who do not have cancer, and prevent unnecessary endoscopies in this group. It could also have an application for colorectal cancer screening.
We propose to determine the diagnostic accuracy of the exhaled breath test for the prediction of colorectal cancer and colonic polyps. This will also involve testing VOCs in urine and colonic air so as to understand the mechanism of VOC production and excretion in humans.
In order to determine the accuracy of the breath test we propose to sample the breath and urine of 2000 patients attending for endoscopy or attending a secondary care consultation over multiple hospitals around London. Patients will be asked to breathe into a breath sampling device, which will take 5-10 minutes. The VOCs in breath are absorbed onto adsorbent tubes, which are then sent to the laboratory for analysis by mass spectrometry. Identify and quantity of VOCs can then be compared in patients with normal colons, benign diseases of the colon, colonic polyps and CRC. Colonic air samples and urine samples will also be analysed using mass spectrometry.REC name
East of England - Essex Research Ethics Committee
REC reference
17/EE/0112
Date of REC Opinion
27 Apr 2017
REC opinion
Further Information Favourable Opinion