The test has produced encouraging results in a clinical study, and will now be tested in a larger trial involving three hospitals in London.
Researchers analysed breath samples of 210 patients using the test. They found that the test can discriminate between malignant and benign oesophageal cancer in patients for the first time.
The test is 90 per cent accurate and provides results in minutes, which can take up to four to six hours to process using other methods. The test can also be applied to detect gastric (stomach) cancer tumours.
According to the researchers, economic modelling showed that the test could save the NHS ?145 million a year because it?s cheaper, faster and easier to perform than other methods.
Oesophageal and gastric malignancies account for 15 per cent of cancer-related deaths globally. Both cancers are usually diagnosed in the advanced stages because they rarely cause any noticeable symptoms when they first develop. As a result, the long-term survival rate is 13 per cent for oesophageal cancer and 15 per cent for gastric cancer in the UK. However, diagnosis of these cancers at an early stage can improve survival rates.
Doctors diagnose oesophageal and gastric cancers by carrying out an endoscopy. This is a procedure where the inside of the body is examined using a probe with a light source and video camera at the end via the mouth and down the gullet. However, the procedure is invasive and costs the NHS around ?400-?600 per endoscopy. Only two per cent of patients who are referred for an endoscopy by GPs are diagnosed with oesophageal or gastric cancer.
The first study, published in the Annals of Surgery, was carried out by an international team led by scientists at Imperial College London and clinicians at Imperial College Healthcare NHS Trust. Researchers from UCL (University College London), Keele University Medical School, Heyrovsky Institute of Physical Chemistry and Academy of Sciences of the Czech Republic were also involved in the study.
Now, 400 patients at UCLH (University College London Hospitals NHS Foundation Trust), The Royal Marsden NHS Foundation Trust, and Guy?s and St Thomas? NHS Foundation Trust will take part in a further trial. The researchers hope to use the findings from the clinical trial to create a sensor device that can signal to clinicians if a patient has a malignant tumour.
Professor George Hanna, lead author of the study and Director of NIHR-Diagnostic Evidence Cooperatives at Imperial College London, said:
?Oesophageal and gastric cancers are on the rise in the UK with more than 16,000 new cases diagnosed each year. The current method for detecting these cancers is expensive, invasive and a diagnosis is usually made at a late stage and often the cancer has spread to other parts of the body. This makes it harder to treat and results in poor long-term survival rates. Our breath test could address these problems because it can help diagnose patients with early non-specific symptoms as well as reduce the number of invasive endoscopies carried out on patients, which often lead to negative results. Diagnosis at an early stage could give patients more treatment options and ultimately save more lives.?
The test looks for chemical compounds in exhaled breath that are unique to patients with oesophageal and gastric cancer. The cancers produce a distinctive smell of volatile organic compounds (VOC), chemicals that contain carbon and are found in all living things, which can help doctors detect early signs of the disease. Researchers were able to identify for the first time the number of VOCs in breath samples by using a selected ion flow tube mass spectrometer, an analytical instrument used to identify what chemicals are present in a sample. This quantitative technology identified VOCs that were present at significantly higher concentrations in patients with oesophageal and gastric cancer than in non-cancerous patients. The researchers say that the results could be used to set a biomarker, a biological feature used to measure the presence or progress of a disease.
To take the test, patients breathe into a device similar to a breathalyser which is connected to a bag. The compounds in their exhaled breath are analysed by a selected ion flow tube mass spectrometer.
The researchers used breath samples of patients with oesophageal and gastric cancer at Imperial College Healthcare NHS Trust from 2011 to 2013. Patients who are at risk of developing these cancers and those who had benign tumours were also tested.
Similar breath tests to discriminate between benign and malignant tumours exist but researchers say they have lengthy processing times and are unable to quantify the amounts of VOCs present in exhaled breath.
The research was funded by NIHR Imperial Biomedical Research Centre and NIHR-diagnostic Evidence Cooperatives.
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About Imperial College AHSC
Imperial College Academic Health Science Centre (AHSC) is a partnership between Imperial College London and Imperial College Healthcare NHS Trust, based in West London.
Established in 2007, it was the first AHSC to be created in the UK and was formally designated by the Department of Health in 2009. The partnership brings together multi-disciplinary research and education from across all faculties at the College with the resources and critical mass of the Trust to advance discovery and innovation within healthcare.
The purpose of Imperial College AHSC is to utilise excellence in research and education to transform health outcomes, and support the UK?s globally competitive position in healthcare related industries by increasing societal and economic gain. The AHSC is nested within Imperial College Health Partners, the Academic Health Science Network for North West London, which will ensure that discoveries and innovations are applied on a national and global scale.
About Imperial College London
Imperial College London is one of the world’s leading universities. The College’s 14,000 students and 7,500 staff are expanding the frontiers of knowledge in science, medicine, engineering and business, and translating their discoveries into benefits for society.
Founded in 1907, Imperial builds on a distinguished past – having pioneered penicillin, holography and fibre optics – to shape the future. Imperial researchers work across disciplines to improve global health, tackle climate change, develop sustainable energy technology and address security challenges. This blend of academic excellence and its real-world application feeds into Imperial’s exceptional learning environment, where students participate in research to push the limits of their degrees.
Imperial nurtures a dynamic enterprise culture, where collaborations with industrial, healthcare and international partners are the norm. In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK’s first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible.
Imperial has nine London campuses, including Imperial West: a new 25 acre research and innovation centre in White City, west London. At Imperial West, researchers, businesses and higher education partners will co-locate to create value from ideas on a global scale.
About Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust comprises Charing Cross, Hammersmith, Queen Charlotte?s & Chelsea, St Mary?s and Western Eye hospitals. With more than one million patient contacts each year, it is one of the largest acute Trusts in the country and, in partnership with Imperial College London, is the UK?s first Academic Health Science Centre (AHSC). It has an annual turnover of around ?950 million.
Imperial College Healthcare is one of eleven NIHR Biomedical Research Centres. This designation is given to the most outstanding NHS and university research partnerships in the country; leaders in scientific translation and early adopters of new insights in technologies, techniques and treatments for improving health. Imperial College Healthcare has some of the lowest mortality rates in the country according to the Dr Foster Guide ? an annual, independent report published 2013.