Journal of Cancer Research and Clinical Oncology

, Volume 145, Issue 1, pp 223–234 | Cite as

Fecal volatile organic compounds for early detection of colorectal cancer: where are we now?

  • Sofie Bosch
  • Daniel J. Berkhout
  • Ilhame Ben Larbi
  • Tim G. de Meij
  • Nanne K. de Boer
Review – Clinical Oncology



The fecal volatolome, which is composed of fecal volatile organic compounds (VOCs), seems to hold potential as non-invasive biomarker for the detection of colorectal cancer (CRC) and its precursor lesions advanced adenomas (AA). The potential of the fecal volatolome has been subject of various studies using either chemical analytical or pattern-recognition techniques. The available literature on the potential of the fecal volatolome as CRC and AA biomarker was reviewed.


A systematic literature search was conducted in PubMed, Embase, the Cochrane Library, Google Scholar and ResearchGate using the following keywords: Colorectal Cancer, Advanced Adenoma, Volatile Organic Compound, Metabolome, Gas Chromatrography–Mass Spectrometry, Selected-Ion Flow-Tube Mass Spectrometry, eNose, and Fecal Biomarkers.


Eighty-eight titles or abstracts were identified from the search, of which 11 papers describing the potential of the fecal volatolome for CRC detection were selected. In these studies, different techniques were used for the headspace analyses of fecal VOCs, limiting the possibility to compare outcomes. Increased levels of amino acids and short chain fatty acids, and decreased levels of bile acids and polyol alcohols in the gas phase of feces were observed repeatedly. All selected papers reported high diagnostic value for the detection of both CRC and AA based on fecal VOCs.


Based on the included studies, fecal VOC analyses seem promising for future screening of CRC and AA, with potentially improved test performances allowing for earlier detection of AA and CRC and consequently earlier initiation of treatment, possibly reducing morbidity and mortality rates next to lower rates of (unnecessary) colonoscopies.


Colorectal carcinoma Advanced adenoma Volatile organic compounds Biomarker Screening 



Advanced adenoma


Area under the curve


Colorectal cancer


Electronic Nose


Fecal immunochemical testing


Fecal occult blood test


Gas chromatography


Gas chromatography–mass spectrometry


Gas chromatography–mass selective detector


Gas chromatography–sulfur chemiluminescence detector


Gas chromatography–thermal conductivity detector


Healthy control


Short chain fatty acid


Selected ion flow tube linked to mass spectrometry


Volatile organic compounds



There was no funding required for the performance of this study.

Compliance with ethical standards

Conflict of interest

S. Bosch declares that she has no conflict of interest. D. J. Berkhout declares that he has no conflict of interest. I. Ben Larbi declares that she has no conflict of interest. Tim G. de Meij served in the advisory board of Danone. Nanne K. de Boer has served as a speaker for AbbVie and MDS. He has served as consultant and principal investigator for TEVA Pharma BV and Takeda. He has received a (unrestricted) grant from Dr. Falk and Takeda.

Human and animal rights statement

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gastroenterology and HepatologyAmsterdam UMC, Vrije Universiteit Amsterdam, AG&M Research InstituteAmsterdamThe Netherlands
  2. 2.Department of Pediatric Gastroenterology, Amsterdam UMCVrije Universiteit AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Pediatric Gastroenterology, Amsterdam UMCUniversity of Amsterdam, Emma Children’s HospitalAmsterdamthe Netherlands

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