Open Access

ARTICLE

Calcium supplementation in colorectal cancer prevention: A systematic meta-analysis of adverse events

XUE MEI LUO¹, SHAHANAVAJ KHAN^2,3,4,*, ABDUL MALIK², FAHAD M. ALDAKHEEL⁵, ANIS AHMAD CHAUDHARY⁶, SHOUKI BAZARBASHI⁷, FATEMEH TABATABAIE⁸

1 Department of General Surgery, Mianzhu People’s Hospital of Sichuan, Mianzhu, China
2 Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
3 Department of Biosciences, Shri Ram Group of College (SRGC), Muzaffarnagar, India
4 Department of Health Sciences, Novel Global Community Educational Foundation, Sydney, Australia
5 Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
6Department of Biology, College of Science, Imam Mohammad Ibn Saud Islamic University (IMSUI), Riyadh, Saudi Arabia
7 Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
8 Shiraz University of Medical Sciences, Shiraz, Iran

* Corresponding Author: SHAHANAVAJ KHAN. Email:

(This article belongs to the Special Issue: Molecular and Cellular Diagnostic Models)

BIOCELL 2022, 46(3), 759-767. https://doi.org/10.32604/biocell.2022.016586

Received 27 March 2021; Accepted 20 May 2021; Issue published 18 November 2021

Abstract

Despite the multiple systematic reviews and meta-analyses accumulating evidence on the preventive effect of calcium supplementation for colorectal cancer, most of the associated adverse effects are not systematically analyzed. The aim of the study is evaluating adverse events associated with calcium supplementation for colorectal cancer prevention through a systematic meta-analysis. We searched Medline, PubMed Central, EMBASE (Excerpta Medica database), Scopus, Cochrane Central Register of Controlled Trials, and Web of Science published in English from database inception up to 31 July 2019. In the current systematic meta-analysis, we included human studies (including cohort studies, clinical trials, case-control studies) on supplementation of calcium in patients with or at risk of colorectal cancer. Assessment of the quality of included studies was performed by Jadad score. Information on the patient population, number of enrolled subjects in each group, dose of calcium supplementation, duration of calcium supplementation, and reported adverse events were gathered. The data were pooled for incidence rates for any adverse event during the study period regardless of causality association. We identified 6 studies, comprising 4583 participants that met the inclusion criteria. Meta-analysis on pooled incidence rates for adverse event during study period showed no statistically significant increased risk for cancer (OR = 0.92, 95% CI: 0.70–1.21, P = 0.577; I² = 0.0%, P = 0.731), coronary revascularization (OR = 1.12, 95% CI: 0.79–1.59, P = 0.492; I² = 0.0%, P = 0.957), myocardial infarction (OR = 0.81, 95% CI: 0.34–1.91, P = 0.634; I² = 67.9%, P = 0.047), stroke (OR = 0.75, 95% CI: 0.42–1.33, P = 0.332, I² = 0.00%, P = 0.717), Transient Ischemic Attack (TIA) (OR = 1.37, 95% CI: 0.28–6.51, P = 0.692, I² = 81.9%, P = 0.002), urolithiasis (OR = 1.23, 95% CI: 0.75–2.01, P = 0.410; I² = 0.0%, P = 0.851), fracture (OR = 0.98, 95% CI: 0.70–1.37, P = 0.938; I² = 37.8%, P = 0.152) and death (OR = 1.05, 95% CI: 0.71–1.56, P = 0.786, I² = 12.2%, P = 0.317) in patients receiving calcium supplementation for colorectal cancer prevention compared to control. Based on the results of Egger test, publication bias was not observed among the studies (P = 0.262). The current result of the meta-analysis on human studies reporting adverse events associated with calcium supplementation for the prevention of colorectal cancer demonstrated no statistically significant increased risk for the development of adverse events compared to control groups.

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