{"entity":{"id":"n-nose","kind":"drug","name":"N-NOSE","aka":[],"tldr":"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).","status":"emerging","asOf":"2026-10-29","links":[{"label":"Hatakeyama et al., Biochemistry and Biophysics Reports 2024","url":"https://doi.org/10.1016/j.bbrep.2024.101778"},{"label":"Real-world N-NOSE analysis, Biomedicines 2024","url":"https://doi.org/10.3390/biomedicines12112546"},{"label":"N-NOSE (Hirotsu Bio Science)","url":"https://lp.n-nose.com/"}],"tags":["test","mced","evidence:insufficient"],"related":[],"cancers":[],"sections":[],"technologies":["mced","liquid-biopsy"],"targets":[],"drugs":[],"companies":["hirotsu-bio-science"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"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)."],"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.","approvals":[],"mechanismSteps":[],"toxicity":[],"access":[{"country":"Japan","listPrice":"19,800 yen single test (16,800 yen offer price to 31 October 2026), company website","source":"https://lp.n-nose.com/","asOf":"2026-10-29"}],"regulatoryEvents":[]},"route":"/drugs/n-nose/","neighbours":{"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mced","kind":"technology","name":"Multi-cancer early detection (MCED)","route":"/technologies/mced/"}],"company":[{"id":"hirotsu-bio-science","kind":"company","name":"Hirotsu Bio Science","route":"/companies/hirotsu-bio-science/"}]}}