Calcium supplementation for the prevention of colorectal adenomas: a systematic review and meta-analysis of randomized controlled trials

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• dc.contributor.author Bonovas, Stefanos
• dc.contributor.author Fiorino, Gionata
• dc.contributor.author Lytras, Theodoros, 1987-
• dc.contributor.author Malesci, Alberto
• dc.contributor.author Danese, Silvio
• dc.date.accessioned 2023-11-20T08:23:05Z
• dc.date.available 2023-11-20T08:23:05Z
• dc.date.issued 2016
• dc.description.abstract To determine the efficacy of calcium supplementation in reducing the recurrence of colorectal adenomas. We conducted a systematic review and meta-analysis of published studies. We searched PubMed, Scopus, the Cochrane Library, the WHO International Clinical Trials Registry Platform, and the ClinicalTrials.gov website, through December 2015. Randomized, placebo-controlled trials assessing supplemental calcium intake for the prevention of recurrence of adenomas were eligible for inclusion. Two reviewers independently selected studies based on predefined criteria, extracted data and outcomes (recurrence of colorectal adenomas, and advanced or “high-risk” adenomas), and rated each trial’s risk-of-bias. Between-study heterogeneity was assessed, and pooled risk ratio (RR) estimates with their 95% confidence intervals (95%CI) were calculated using fixed- and random-effects models. To express the treatment effect in clinical terms, we calculated the number needed to treat (NNT) to prevent one adenoma recurrence. We also assessed the quality of evidence using GRADE. Four randomized, placebo-controlled trials met the eligibility criteria and were included. Daily doses of elemental calcium ranged from 1200 to 2000 mg, while the duration of treatment and follow-up of participants ranged from 36 to 60 mo. Synthesis of intention-to-treat data, for participants who had undergone follow-up colonoscopies, indicated a modest protective effect of calcium in prevention of adenomas (fixed-effects, RR = 0.89, 95%CI: 0.82-0.96; random-effects, RR = 0.87, 95%CI: 0.77-0.98; high quality of evidence). The NNT was 20 (95%CI: 12-61) to prevent one colorectal adenoma recurrence within a period of 3 to 5 years. On the other hand, the association between calcium treatment and advanced adenomas did not reach statistical significance (fixed-effects, RR = 0.92, 95%CI: 0.75-1.13; random-effects, RR = 0.92, 95%CI: 0.71-1.18; moderate quality of evidence). Our results suggest a modest chemopreventive effect of calcium supplements against recurrent colorectal adenomas over a period of 36 to 60 mo. Further research is warranted.
• dc.format.mimetype application/pdf
• dc.identifier.citation Bonovas S, Fiorino G, Lytras T, Malesci A, Danese S. Calcium supplementation for the prevention of colorectal adenomas: a systematic review and meta-analysis of randomized controlled trials. World J Gastroenterol. 2016 May 14;22(18):4594-603. DOI: 10.3748/wjg.v22.i18.4594
• dc.identifier.doi http://dx.doi.org/10.3748/wjg.v22.i18.4594
• dc.identifier.issn 1007-9327
• dc.identifier.uri http://hdl.handle.net/10230/58303
• dc.language.iso eng
• dc.publisher Baishideng Publishing Group
• dc.relation.ispartof World Journal of Gastroenterology. 2016 May 14;22(18):4594-603
• dc.rights This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
• dc.subject.keyword Calcium
• dc.subject.keyword Colorectal adenoma
• dc.subject.keyword Recurrence
• dc.subject.keyword Cancer chemoprevention
• dc.subject.keyword Colorectal cancer
• dc.subject.keyword Systematic review
• dc.subject.keyword Meta-analysis
• dc.subject.keyword Polyp
• dc.title Calcium supplementation for the prevention of colorectal adenomas: a systematic review and meta-analysis of randomized controlled trials
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion