Research Involvement Network opportunity: Development of a breath test to detect pancreatic cancer

Provide your feedback and help to shape a project that is developing a breath test to detect pancreatic cancer

Professor George Hanna and his team at Imperial College London are aiming to develop a non-invasive breath test to detect cancer of the pancreas at an early stage. The test is based on the detection of volatile organic compounds (VOCs), small molecules in breath, that are produced by pancreatic cancer.

Patients with early pancreatic cancer often have non-specific symptoms typical of common non-cancer conditions. In comparison, ‘Red flag’ symptoms linked to pancreatic cancer often indicate advanced incurable disease. Currently only patients with ‘red flag’ symptoms are urgently referred for diagnostic testing. The proposed breath test will be used to assess patients presenting with non-specific symptoms of pancreatic cancer who are not eligible for referral under existing guidelines. The test will help GPs better decide which patients would most benefit from referral for specialised investigations.

The team has previously developed a breath test to detect stomach, oesophagus and colon cancers and conducted clinical trials in more than 2000 patients. The breath test has an accuracy of about 90% to detect those cancers and the team have found breath testing to be simple and acceptable to patients. Currently, this work is undergoing large-scale confirmation studies, but shows promise, and now Professor Hanna wants to target pancreatic cancer.

Professor Hanna is planning to apply to Pancreatic Cancer UK to fund this research. He is asking for support from the Research Involvement Network to provide feedback on the design of the study and the grant application.

What the opportunity involves and the next steps 

Research Involvement Network members that would like to take part will be sent the application (including a lay summary, without any scientific words/jargon) and some questions that Professor Hanna would like them to consider as part of their feedback. Feedback can be given either by attending a focus group on Tuesday 15th February 11.30-13.00 or by providing written comments.

If you would like to give written feedback, attend the focus group or have any further questions about this opportunity, please email the Research Team ( The deadline for sending your feedback is Monday 21st February 2022.

More about the Breath Test study 


The aims of the programme are to:

(i) determine the mechanisms of VOC production in pancreatic cancer,
(ii) develop and validate breath test to detect pancreatic cancer in symptomatic patients.


(i) Mechanisms responsible for the production of VOCs in pancreatic cancer

The team will establish a resource of samples from pancreatic cancer and healthy control patients to study the source of VOC production. They will examine how bacteria that are associated with pancreatic cancer may influence VOC production. Findings will confirm the genetic and metabolic origins of VOC in pancreatic cancer.

(ii) Multicentre trial of the enhanced breath test

The team will administer the enhanced breath test to over 5000 patients with suspected pancreatic cancer referred from primary care for endoscopy. This trial will establish the performance of the test in symptomatic patients.

The team will continue to work with patients and wider stakeholders to understand their feelings about early detection of pancreatic cancer and breath testing. They will examine how the test would be used within the NHS and seek to understand any barriers to its adoption. They will also look at the cost benefits of the test and will raise awareness for the test and share findings of their research through pancreatic cancer forums and charitable organisations.

The benefits to people affected by pancreatic cancer

To overcome the challenge of earlier detection of pancreatic cancer the team propose a non-invasive breath test to identify patients at risk of the disease as a means of ‘triage’ before further investigation with existing diagnostic methods. Breath testing has ideal characteristics for a triage test, being non-invasive, simple to undertake and universally acceptable to patients of all ethnicities. Such a test will directly benefit patients presenting with non-specific symptoms who don’t meet existing criteria (“red-flag” symptoms) for referral, offering them an accessible, acceptable and accurate method of assessment for pancreatic cancer.

The study will also provide reassurance to the majority of patients without cancer and the healthcare service will benefit from a more cost-effective pathway for diagnosing pancreatic cancer.