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Post-diagnosis dietary factors, supplement use and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta-analysis.

International journal of cancer
January 1, 1970
Doris S M Chan et al. (30 authors)
Journal ArticleSystematic ReviewMeta-AnalysisHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the association between supplemental calcium and colorectal cancer survival outcomes, including all-cause and cancer-specific mortality.

Results Summary

The study found limited evidence for an association between supplemental calcium and colorectal cancer-specific mortality, with the overall evidence graded as 'limited-no conclusion.' No strong or clinically meaningful effects were demonstrated.

Population

Colorectal cancer survivors (30,242 cases included in the analysis).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (24)
InterventionDirectionEndpointPopulationDosageImpactClaim #
healthy dietary and/or lifestyle patterns (including diets that comprised plant-based foods)
decrease
all-cause mortality
colorectal cancer survivors
-
inverse associations
#1
whole grains
decrease
all-cause mortality
colorectal cancer survivors
-
inverse associations
#2
total coffee
decrease
all-cause mortality
colorectal cancer survivors
-
inverse associations
#3
caffeinated coffee
decrease
all-cause mortality
colorectal cancer survivors
-
inverse associations
#4
decaffeinated coffee
decrease
all-cause mortality
colorectal cancer survivors
-
inverse associations
#5
unhealthy dietary patterns
increase
all-cause mortality
colorectal cancer survivors
-
positive associations
#6
sugary drinks
increase
all-cause mortality
colorectal cancer survivors
-
positive associations
#7
whole grains
neutral
all-cause mortality
colorectal cancer survivors
-
-
#8
nuts/peanuts
neutral
all-cause mortality
colorectal cancer survivors
-
-
#9
red and processed meat
neutral
all-cause mortality
colorectal cancer survivors
-
-
#10
dairy products
neutral
all-cause mortality
colorectal cancer survivors
-
-
#11
sugary drinks
neutral
all-cause mortality
colorectal cancer survivors
-
-
#12
artificially sweetened beverages
neutral
all-cause mortality
colorectal cancer survivors
-
-
#13
coffee
neutral
all-cause mortality
colorectal cancer survivors
-
-
#14
alcohol
neutral
all-cause mortality
colorectal cancer survivors
-
-
#15
dietary glycaemic load/index
neutral
all-cause mortality
colorectal cancer survivors
-
-
#16
insulin load/index
neutral
all-cause mortality
colorectal cancer survivors
-
-
#17
marine omega-3 polyunsaturated fatty acids
neutral
all-cause mortality
colorectal cancer survivors
-
-
#18
supplemental calcium
neutral
all-cause mortality
colorectal cancer survivors
-
-
#19
circulating 25-hydroxyvitamin D (25[OH]D)
neutral
all-cause mortality
colorectal cancer survivors
-
-
#20
alcohol
neutral
colorectal cancer-specific mortality
colorectal cancer survivors
-
-
#21
supplemental calcium
neutral
colorectal cancer-specific mortality
colorectal cancer survivors
-
-
#22
circulating 25(OH)D
neutral
colorectal cancer-specific mortality
colorectal cancer survivors
-
-
#23
circulating 25(OH)D
neutral
recurrence/disease-free survival
colorectal cancer survivors
-
-
#24
Abstract

The role of diet in colorectal cancer prognosis is not well understood and specific lifestyle recommendations are lacking. We searched for randomised controlled trials (RCTs) and longitudinal observational studies on post-diagnosis dietary factors, supplement use and colorectal cancer survival outcomes in PubMed and Embase from inception until 28th February 2022. Random-effects dose-response meta-analyses were conducted when at least three studies had sufficient information. The evidence was interpreted and graded by the CUP Global independent Expert Committee on Cancer Survivorship and Expert Panel. Five RCTs and 35 observational studies were included (30,242 cases, over 8700 all-cause and 2100 colorectal cancer deaths, 3700 progression, recurrence, or disease-free events). Meta-analyses, including 3-10 observational studies each, were conducted for: whole grains, nuts/peanuts, red and processed meat, dairy products, sugary drinks, artificially sweetened beverages, coffee, alcohol, dietary glycaemic load/index, insulin load/index, marine omega-3 polyunsaturated fatty acids, supplemental calcium, circulating 25-hydroxyvitamin D (25[OH]D) and all-cause mortality; for alcohol, supplemental calcium, circulating 25(OH)D and colorectal cancer-specific mortality; and for circulating 25(OH)D and recurrence/disease-free survival. The overall evidence was graded as 'limited'. The inverse associations between healthy dietary and/or lifestyle patterns (including diets that comprised plant-based foods), whole grains, total, caffeinated, or decaffeinated coffee and all-cause mortality and the positive associations between unhealthy dietary patterns, sugary drinks and all-cause mortality provided 'limited-suggestive' evidence. All other exposure-outcome associations provided 'limited-no conclusion' evidence. Additional, well-conducted cohort studies and carefully designed RCTs are needed to develop specific lifestyle recommendations for colorectal cancer survivors.

Medical Subject Headings (MeSH)
HumansColorectal NeoplasmsDietDietary SupplementsObservational Studies as TopicPrognosisRandomized Controlled Trials as TopicVitamin D
Study Links
Quality Scores
SafetyNot Assessed
Efficacy50/10
Quality75/10
Citation Metrics
Total Citations10
Citations/Year10.0
Relative Citation Ratio4.49
Research Impact Scores
APT Score0.75
Weight Score1.59
Normalized Score0.55
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