Editorial
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Oct 25, 2018; 9(3): 59-62
Published online Oct 25, 2018. doi: 10.4291/wjgp.v9.i3.59
Calcium and vitamin D in the serrated neoplastic pathway: Friends or foes?
Natalia García-Morales, Carla Satorres, Marco Bustamante-Balén
Natalia García-Morales, Carla Satorres, Marco Bustamante-Balén, Gastrointestinal Endoscopy Unit, Digestive Diseases Department, La Fe Polytechnic University Hospital, Valencia 46026, Spain
Carla Satorres, Marco Bustamante-Balén, Gastrointestinal Endoscopy Research Group, IIS Hospital La Fe, Valencia 46026, Spain
Author contributions: García-Morales N drafted the initial manuscript; Satorres C performed the literature research and reviewed the manuscript draft; Bustamante-Balén M contributed to conception and design of the project and revised the article critically for important intellectual content.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: 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/
Correspondence to: Marco Bustamante-Balén, MD, PhD, Staff Physician, Gastrointestinal Endoscopy Unit, Gastrointestinal Endoscopy Research Group, La Fe University Hospital, Avda. Fernando Abril Martorell, 106, Valencia 46026, Spain. bustamante_mar@gva.es
Telephone: +34-961-2440225 Fax: +34-961-246278
Received: July 24, 2018
Peer-review started: July 24, 2018
First decision: August 8, 2018
Revised: September 11, 2018
Accepted: October 9, 2018
Article in press: October 9, 2018
Published online: October 25, 2018
Processing time: 93 Days and 11.7 Hours
Abstract

Sessile serrated adenoma/polyps (known as SSA/Ps) may play an important role in the development of interval colorectal cancer (CRC). These lesions are more difficult to detect with conventional endoscopy and they may quickly turn into CRC, especially when dysplasia has developed. Therefore, primary or secondary chemoprevention may be an appealing strategy at a population level. Calcium and vitamin D have been shown in epidemiological studies to reduce the risk of CRC and conventional adenomas, but the evidence regarding their effect on SSA/Ps is controversial. In this editorial we comment on the results of a recent randomized controlled trial investigating the effect of calcium and vitamin D on the development of serrated lesions, summarizing the possible antineoplastic mechanisms of calcium and vitamin D, and discussing the differences found with previous observational reports.

Keywords: Serrated polyps; Sessile serrated polyp; Vitamin D; Calcium; Colorectal cancer

Core tip: Calcium and vitamin D have been shown in epidemiological studies to reduce the risk of colorectal cancer and adenomas, but the evidence regarding their effect on sessile serrated adenomas/polyps (SSA/P) is controversial - some studies showing no effect and others showing some degree of risk reduction. Recently, a randomized controlled trial with calcium and vitamin D supplements was published, concluding that the relative risk of developing a SSA/P was increased in patients taking calcium and vitamin D/calcium. In this editorial we try to place these surprising results into context, describing the limitations of this and previous studies on this topic.