# N-NOSE

Source: https://onco.cc/drugs/n-nose/  
OnCo record `n-nose` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A Japanese urine test that uses the sense of smell of tiny worms; it is sold directly to the public in Japan, does not say which cancer, and in a real-world analysis about 2 in 100 people with a positive result were found to have cancer (about 12 in 100 after allowing for cancers the follow-up scan can miss).

## Summary

Hirotsu Bio Science (Tokyo, established August 2016) sells N-NOSE directly in Japan; its site lists 23 cancer types with a confirmed response and a sensitivity of 88.57% (company figures) and states that it is not a test that diagnoses cancer. The company-authored study (Hatakeyama et al., Biochemistry and Biophysics Reports 2024) reports detection of more than 20 cancer types with sensitivities of 60% to 90% in over 1,600 people with cancer, without a specificity. A real-world analysis (Biomedicines 2024) gives an apparent positive predictive value of 2.09%, about 11.7% after adjusting for the sensitivity of the PET-CT follow-up. The site lists 16,800 yen for a single test (regular price 19,800 yen, offer to 31 October 2026).

## Fields

- Kind: Treatment
- Status: emerging
- Last checked: 2026-10-29
- Tags: test; mced; evidence:insufficient
- Brand: N-NOSE
- Modality: Cancer risk urine test (nematode smell response)
- Mechanism: Tiny roundworms (Caenorhabditis elegans) are drawn towards or away from a drop of urine according to its smell; the developer reads the response as a cancer risk signal. It does not say which cancer.

## Notes

- Evidence grade insufficient for the claim that taking this test reduces late-stage diagnosis or cancer deaths: no randomised trial of it has reported either outcome, and its published performance comes from case-control or single-arm studies. The only randomised result for any multi-cancer test, NHS-Galleri, did not show fewer stage III or IV cancers.
- In the real-world analysis about 98 in 100 positive results did not lead to a cancer diagnosis at follow-up PET-CT; the authors' adjusted estimate is about 88 in 100.
- What a result means: a positive result is a reason for further tests, not a diagnosis; a negative result does not rule cancer out and does not replace the screening tests that have been shown to work (bowel, breast, cervical and, where eligible, lung screening).

## Sources

- Hatakeyama et al., Biochemistry and Biophysics Reports 2024: https://doi.org/10.1016/j.bbrep.2024.101778
- Real-world N-NOSE analysis, Biomedicines 2024: https://doi.org/10.3390/biomedicines12112546
- N-NOSE (Hirotsu Bio Science): https://lp.n-nose.com/

## Connected records

- technologies: [Liquid biopsy (ctDNA)](https://onco.cc/technologies/liquid-biopsy/), [Multi-cancer early detection (MCED)](https://onco.cc/technologies/mced/)
- companies: [Hirotsu Bio Science](https://onco.cc/companies/hirotsu-bio-science/)

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