Effect of longterm placebo controlled calcium supplementation on sigmoidal cell proliferation in patients with sporadic adenomatous polyps.

A longterm, double blind intervention trial was undertaken in patients with sporadic adenoma treated by polypectomy to investigate the putative role of calcium as a protective factor in colon carcinogenesis. The aim of the study was to assess the effect of a daily dietary supplementation of 2 g calcium over nine months on cell proliferation measured as proliferation index in colonic mucosa. A total of 48 patients were entered into the study of which 30 were fully compliant. After intervention proliferation index % (mean (SEM) in colonic epithelium was decreased in both the calcium (13.5 (1.5) to 11.4 (1.2)) and the placebo group (13.7 (0.9) to 10.8 (1.1)). The difference in the change between the two groups was not significant (p = 0.7). Changes in proliferation index % of crypt compartments were also not significantly different between the two groups. A significantly positive correlation between soluble calcium in faeces and the total proliferation index % in colonic epithelium at baseline and after intervention (r = 0.54, p < 0.01, r = 0.50, p < 0.01 respectively) suggests that an increase of free luminal calcium alone is insufficient for inhibition of cellular proliferation.