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000177909 041__ $$aEnglish
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000177909 1001_ $$00000-0002-1582-3224$$aChandrapalan, Subashini$$b0
000177909 245__ $$aSystematic review with meta-analysis: volatile organic compound analysis to improve faecal immunochemical testing in the detection of colorectal cancer.
000177909 260__ $$aOxford$$bWiley-Blackwell$$c2021
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000177909 520__ $$aFaecal immunochemical test (FIT) is emerging as a valid test to rule-out the presence of colorectal cancer (CRC). However, the accuracy of FIT is dependent on the cut-off applied. An additional low-cost test could improve further detection of CRC.To evaluate the efficacy of combined FIT and volatile organic compounds (VOC) in the detection of CRC within symptomatic populations.Systematic reviews on the diagnostic accuracy of FIT and VOC, for the detection of CRC, were updated. Meta-analyses were performed adopting a bivariate model for sensitivity and specificity. Clinical utility of combined FIT and VOC was estimated using Fagan's nomogram. Post-test probability of FIT negatives was used as a pre-test probability for VOC.The pooled sensitivity and specificity of FIT at 10 µg/g faeces, for the detection of CRC, were 0.914 (95% confidence interval [CI] = 0.894-0.936) and 0.783 (CI = 0.850-0.696), respectively. For VOC, the sensitivity was 0.837 (CI = 0.781-0.881) and the specificity was 0.803 (CI = 0.870-0.712). The area under the curve for FIT and VOC were 0.926 and 0.885, respectively. In a population with 5% CRC prevalence, the estimated probability of having CRC following a negative FIT was 0.5% and following both negative FIT and VOC was 0.1%.In a FIT-negative symptomatic population, VOC can be a good test to rule-out the presence of CRC. The estimated probability reduction by 0.4% when both tests being negative offers adequate safety netting in primary care for the exclusion of CRC. The number needed to colonoscope to identify one CRC is eight if either FIT or VOC positive. Cost-effectiveness and clinical accuracy of this approach will need further evaluation.
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000177909 650_7 $$2NLM Chemicals$$aVolatile Organic Compounds
000177909 650_2 $$2MeSH$$aColorectal Neoplasms: diagnosis
000177909 650_2 $$2MeSH$$aColorectal Neoplasms: epidemiology
000177909 650_2 $$2MeSH$$aEarly Detection of Cancer
000177909 650_2 $$2MeSH$$aFeces
000177909 650_2 $$2MeSH$$aHumans
000177909 650_2 $$2MeSH$$aOccult Blood
000177909 650_2 $$2MeSH$$aSensitivity and Specificity
000177909 650_2 $$2MeSH$$aVolatile Organic Compounds
000177909 7001_ $$00000-0001-9202-1674$$aBosch, Sofie$$b1
000177909 7001_ $$00000-0002-9994-4831$$aCubiella, Joaquín$$b2
000177909 7001_ $$aGuardiola, Jordi$$b3
000177909 7001_ $$aKimani, Peter$$b4
000177909 7001_ $$aMulder, Chris$$b5
000177909 7001_ $$aPersaud, Krishna$$b6
000177909 7001_ $$ade Meij, Tim G J$$b7
000177909 7001_ $$aAltomare, Donato F$$b8
000177909 7001_ $$0P:(DE-He78)90d5535ff896e70eed81f4a4f6f22ae2$$aBrenner, Herman$$b9$$udkfz
000177909 7001_ $$ade Boer, Nanne K H$$b10
000177909 7001_ $$00000-0003-2568-6208$$aRicciardiello, Luigi$$b11
000177909 7001_ $$00000-0002-2231-3062$$aArasaradnam, Ramesh P$$b12
000177909 77318 $$2Crossref$$3journal-article$$a10.1111/apt.16405$$bWiley$$d2021-05-18$$n1$$p14-23$$tAlimentary Pharmacology & Therapeutics$$v54$$x0269-2813$$y2021
000177909 773__ $$0PERI:(DE-600)2003094-0$$a10.1111/apt.16405$$gVol. 54, no. 1, p. 14 - 23$$n1$$p14-23$$tAlimentary pharmacology & therapeutics$$v54$$x0269-2813$$y2021
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