膳食补钙预防结直肠癌和腺瘤性息肉。

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马文加滕，李志强，李志强

膳食补钙预防结直肠癌和腺瘤性息肉。

Cochrane Database Syst Rev. 2005 7月20日;(3):CD003548。

PubMed ID

16034903 (PubMed视图

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摘要

背景:在工业化国家，一些饮食因素被认为与结直肠癌发病率的增加有关。实验和流行病学证据表明，高膳食钙摄入量具有保护作用，但不是结论性的。以结直肠癌为终点的干预研究因患者数量多、随访时间长而难以开展;因此，在回顾现有证据时，考虑使用结直肠腺瘤性息肉外观作为替代终点的研究。目的:本系统综述旨在评估补充膳食钙对结直肠癌发病率和腺瘤性息肉发病率或复发的影响。检索策略:我们检索了Cochrane对照试验注册、Cochrane结直肠癌组专门注册、MEDLINE、Cancerlit和Embase，直到2002年4月。对已确定的研究的参考文献进行了进一步的研究，并对文献进行了详细的审查。选择标准:对膳食钙对人类结肠癌和腺瘤性息肉发展影响的随机对照试验进行了综述。考虑了健康成年人的研究以及由于家族史、既往腺瘤性息肉或炎症性肠病而具有较高结肠癌风险的成年人的研究;排除了家族性大肠息肉病受试者的数据。 The primary outcomes were the occurrence of colon cancer, and occurrence or recurrence of any new adenomas of the colon. Secondary outcomes were any adverse event that required discontinuation of calcium supplementation, and drop-outs before the end of the study. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data, assessed trial quality and resolved discrepancies by consensus. The outcomes were reported as odds ratios (OR) with 95% confidence intervals (CI). The data were combined with the fixed effects model. MAIN RESULTS: Two studies with 1346 subjects met the inclusion criteria. Both trials were well designed, double - blind, placebo controlled trials, included participants with previous adenomas. The doses of supplementary elemental calcium used were 1200 mg daily for a mean duration of 4 years, and 2000 mg/day for three years. The rates of loss to follow -up were 14 % and 11%. For the development of recurrent colorectal adenoma, a reduction was found (OR 0.74, CI 0.58,0.95) when the results from both trials were combined. AUTHORS' CONCLUSIONS: Although the evidence from two RCTs suggests that calcium supplementation might contribute to a moderate degree to the prevention of colorectal adenomatous polyps, this does not constitute sufficient evidence to recommend the general use of calcium supplements to prevent colorectal cancer.

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