On a global scale cancers of the mouth, nose, sinuses, and throat make up 6% of all cancer diagnosis and these forms of the disease kill over 300,000 patients annually with those who use tobacco, alcohol and practice poor oral hygiene being the most at risk for illness. The researchers from Flinders University report making a significant breakthrough in using exhaled particles to tell who does or does not have these cancers of the head and neck.
181 patients were involved in this study who were believed to have early-stage head and neck squamous cell carcinoma, breath samples were taken from the patients to investigate if the new test could determine the specific differences in cancer patients without the need for a biopsy.
“We sought to determine the diagnostic accuracy of breath analysis as a non-invasive test for detecting head and neck cancer, which in time may result in a simple method to improve treatment outcomes and patient morbidity,” says lead researchers Dr. Roger Yazbek and Associate Professor Eng Ooi.
An ion flow tube mass spectrometer is used to check for volatile organic compounds in the patient samples; findings published in the British Journal of Cancer indicate that the breath test can correctly distinguish between cancer compounds and healthy control patients with an average sensitivity and specificity rating of 85% and thees diagnosis were confirmed via standard tissue biopsy.
As there appears to be a surge in cases of head and neck cancers among younger people which has been linked to complications from the human papillomavirus, this breath test may be a fast, non-invasive, and inexpensive way to get an early diagnosis to help get people into treatment sooner. Treatments are more effective during the early stage of the disease, while the diagnosis of head and neck cancers in their later stage is common these cases have poorer survival rates.
“With these strong results, we hope to trial the method in primary care settings, such as GP clinics, to further develop its use in early-stage screening for HNSCC in the community,” says co-lead author Dr. Nuwan Dharmawardana.
Abstract:
Background
Improving the ability to identify early-stage head and neck squamous cell carcinoma (HNSCC) can improve treatment outcomes and patient morbidity. We sought to determine the diagnostic accuracy of breath analysis as a non-invasive test for detecting HNSCC.
Methods
Standardised breath samples were collected from 181 patients suspected of HNSCC prior to any treatment. A selected ion flow-tube mass spectrometer was used to analyse breath for volatile organic compounds. Diagnosis was confirmed by histopathology. A binomial logistic regression model was used to differentiate breath profiles between cancer and control (benign disease) patients based on mass spectrometry derived variables.
Results
In all, 66% of participants had early-stage primary tumours (T1 and T2) and 58% had regional node metastasis. The optimised logistic regression model using three variables had a sensitivity and specificity of 80% and 86%, respectively, with an AUC for ROC curve of 0.821 (95%CI 0.625–1.0) in the testing cohort.
Conclusions
Breath analysis for non-invasive diagnosis of HNSCC appears to be practical and accurate. Future studies should be conducted in a primary care setting to determine the applicability of breath analysis for early identification of HNSCC.
