Combined low dietary calcium intake (<800 mg/day; IOM RDA 1000-1200 mg/day age-dependent)...
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | RF-LIFESTYLE-LOW-CALCIUM-VIT-D-CRC-PREVENTION |
|---|---|
| Тип | Тривожна ознака |
| Статус | переглянуто 2026-05-18 | очікує клінічного підпису |
| Хвороби | DIS-CRC |
| Джерела | SRC-NCCN-BCELL-2025 SRC-NCCN-COLON-2025 |
Походження тривожної ознаки
| Визначення | Combined low dietary calcium intake (<800 mg/day; IOM RDA 1000-1200 mg/day age-dependent) AND vitamin D deficiency (serum 25-hydroxy- vitamin D <30 nmol/L per IOM threshold, <50 nmol/L per Endocrine Society). WCRF/AICR Continuous Update Project rates dietary calcium as "probable" protective for colorectal cancer — meta-analyzed RR ~0.92 per 300 mg/day calcium intake. Vitamin D status (circulating 25-OH-D) is associated with CRC risk in observational cohorts (~30% incidence reduction in highest vs lowest quartile per IARC pooled analysis); causal RCT evidence is mixed (VITAL, ViDA trials did not show primary CRC-incidence reduction at population doses but signal for CRC mortality reduction with vitamin D supplementation). Mechanisms: calcium binds bile acids + fatty acids in colonic lumen reducing mucosal cytotoxicity; vitamin D regulates colonocyte proliferation + differentiation via VD... |
|---|---|
| Клінічний напрям | investigate |
| Категорія | other |
Логіка спрацьовування
{
"all_of": [
{
"finding": "dietary_calcium_intake_lt_800mg_per_day",
"value": true
},
{
"finding": "serum_25oh_vitamin_d_lt_30nmol_per_l",
"value": true
}
],
"type": "lab_value"
}
Нотатки
Prevention-persona RedFlag for combined low calcium intake + vitamin D deficiency. WCRF/AICR probable-evidence for calcium and CRC; IARC pooled signal for vitamin D status. RCT evidence for supplementation is mixed at population doses — counseling emphasizes adequate intake/repletion not pharmacologic dosing. Engine routes to PreventionPlan recommending dietary counseling + vitamin D repletion + CRC screening per USPSTF. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.
Де використовується
Indications
IND-LIFESTYLE-LOW-CALCIUM-VIT-D-CRC-PREVENTION-OBSERVATION- IND-LIFESTYLE-LOW-CALCIUM-VIT-D-CRC-PREVENTION-OBSERVATIONIND-LIFESTYLE-LOW-CALCIUM-VIT-D-CRC-PREVENTION-REPLETION- IND-LIFESTYLE-LOW-CALCIUM-VIT-D-CRC-PREVENTION-REPLETION