Volatile organic compounds and the potential for a lung cancer breath test

Detecting exhaled volatile organic compounds (VOCs) that are associated with lung cancer (LC) has realistic potential for becoming an integral part of populationbased LC screening and monitoring in the near future. Here, we review the main three approaches for profiling VOCs in LC patients and their advantages and pitfalls: first, mass spectrometry techniques for the identification and/or quantification of a wide variety of separate breath VOCs; second, canines that are trained to sniff out LC; and third, crossreactive chemical sensors in combination with statistical methods for identifying diseasespecific patterns. We estimate that the latter would be most suitable for clinical practice. In the short run, breath testing could provide a critically needed adjunct method for detecting nodule malignancy with high specificity during low-dose computed tomography screening. In the long run, breath testing holds potential for entirely revolutionizing LC screening, diagnosis and management.