Chandrapalan S, Bosch S, Cubiella J, et al. - In this study, the efficacy of combined fecal immunochemical test (FIT) and volatile organic compounds (VOC) in the detection of colorectal cancer (CRC) within symptomatic populations was explored. Researchers conducted meta-analyses adopting a bivariate model for sensitivity and specificity. Fagan's nomogram was used to calculate the clinical utility of combined FIT and VOC. They used the Post-test probability of FIT negatives as a pre-test probability for VOC. VOC can be a good test to rule out the presence of CRC in a FIT-negative symptomatic population. The results showed that the estimated probability reduction by 0.4% when both tests being negative offers adequate safety netting in primary care for the exclusion of CRC. As per the results, the number needed to colonoscope to distinguish one CRC is eight whether either FIT or VOC positive. Cost-effectiveness and clinical accuracy of this approach will need future assessment.