New technology capable of detecting minute changes in exhaled breath could help signal the onset of gastric cancer. Scientists developed the accurate and inexpensive method of analysing certain atoms from breath samples thanks in part to a EUR 1.2 million FP7 European Research Council (ERC) grant. Some landmark findings have just been published in the academic journal Gut. Completed at the end of 2014, the DIAG-CANCER project represents an important breakthrough in effective cancer screening and prevention. Until recently, widespread screening has only been available for a few cancers, most notably cervical cancer, where the management of screen-detected lesions has reduced incidences by 80 %. When it comes to gastric cancer in Europe however, most patients have until now been diagnosed in the advanced stages of the disease. The four-year DIAG-CANCER project sought to find a new, inexpensive means of distinguishing between malignant and non-malignant gastric conditions. The team harnessed the potential of nanotechnology, which uses materials at the atomic, molecular and even macromolecular scale, where properties differ significantly from those at a larger scale. The chemical nature of certain cancer biomarkers were also identified through spectrometry, an analytical chemistry technique that helps identify chemicals present in a sample. For the gastric cancer breath test, a total of 968 breath samples were collected from 484 patients (including 99 with gastric cancer). Researchers reported that patients with cancer – as well as those at high risk – had distinctive breath-print compositions. They found that systematic oxidative stress – a condition that is thought to be involved in the development of cancer – generates alkanes such as ethane, pentane, and other saturated hydrocarbons. A total of eight of these significant volatile organic compounds were detected in exhaled breath in the different comparisons. Most significantly, the prototype test proved capable of identifying different stages of precancerous gastric lesions. Furthermore, the presence of precancerous stomach lesions could be detected whether or not other factors, such as smoking or heavy alcohol consumption, were in play. In fact, the analysis developed by the DIAG-CANCER team was capable of discriminating between patients with gastric cancer and the control group with a reported accuracy level of 92 %. Researchers also believe that the breath test has huge potential as an invaluable follow-up tool for the surveillance of high-risk patients, and could be used to detect for other diseases and lesions. It is hoped that the new breath test can effectively address this critical weakness. After all, early diagnosis plays a significant role in determining a patient’s chances of survival. DIAG-CANCER’s simple breath test analysis could soon provide the missing non-invasive screening tool for gastric cancer and related precancerous lesions, offering hopes to thousands of at-risk patients. Finally, as the test can be administered outside specialist settings, it also has the potential to lessen the burden on healthcare budgets, both through simple low-cost testing and through earlier and thus more cost-effective treatment.