Accuracy of breath tests for colorectal neoplasms diagnosis: a meta-analysis

Early noninvasive and rapid screening for colorectal cancer critically influences treatment outcomes. Breath testing, as an emerging screening technology, allows for noninvasive and convenient screening for different biomarkers and is a reliable screening method for various diseases. In this study, a meta-analysis of the accuracy and current status of volatile organic compounds present in exhaled breath for colorectal cancer detection was performed. PubMed, Cochrane Library, and CNKI were searched for relevant studies. The quality of the studies was assessed using the QUADAS-2 criteria, and meta-analysis was performed using RevMan 5.3 and Stata 16. The pooled sensitivity is 90% [95% confidence interval (CI), 85-94%], the pooled specificity is 86% (95% CI, 72-93%), the pooled positive likelihood ratio is 6.3 (95% CI, 3.1-12.6), the negative likelihood ratio is 0.11 (95% CI, 0.07-0.17), and the diagnostic odds ratio is 56 (95% CI, 23-133). Summary receiver operating characteristic analysis revealed an area under the curve of 0.94 (95% CI, 0.91-0.95). The alteration of specific components of exhaled breath is associated with colorectal cancer development, and the selection of biomarkers and detection instruments influence the diagnostic value. What this paper adds to the literature: this meta-analysis provides a comprehensive evaluation of the diagnostic accuracy of volatile organic compounds in breath tests for colorectal cancer, highlighting the influence of biomarker selection and detection methods on screening efficacy.