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Folate intake and the risk of colorectal cancer: a systematic review and meta-analysis.

Abstract

INTRODUCTION

Folic acid fortification and supplementation to prevent neural tube defects has led to concerns regarding increased risk of colorectal cancer. The results of existing studies have been inconclusive. The purpose was to examine the relationship between level of folate intake and the incidence of colorectal cancer.

METHODS

A systematic review and meta analysis were conducted. MEDLINE, Embase, and SCOPUS were searched from inception to October 2009 with the following search terms "folic acid," "folate", "colorectal cancer," "colon neoplasms," rectal neoplasms." Observational studies in adult populations were included that defined levels of folate intake and incidence of colorectal cancer.

RESULT

Out of 6427 references, 27 studies met our inclusion criteria. The summary risk estimate for case control studies comparing high versus low total folate intake was 0.85 (CI 95% 0.74-0.99) with no significant heterogeneity among studies. Similarly, for cohort studies, the resulting summary risk estimate for high versus low dietary folate intake was 0.92 (CI 95% 0.81-1.05) with no significant heterogeneity. However, defining what represents a higher intake of folic acid is difficult as there is variability in the upper limit of folic acid intake used in the studies.

DISCUSSION

These results suggest that higher folate intake levels offer a reduction in one of the perceived risks associated with developing colorectal cancer. These data can serve to help reassure women planning a pregnancy to increase folic intake during the preconception period to levels sufficient to prevent neural tube defects.

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  • Authors+Show Affiliations

    ,

    The Motherisk Program, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8 Canada. dkennedy@ccnm.edu

    , , , , ,

    Source

    Cancer epidemiology 35:1 2011 Feb pg 2-10

    MeSH

    Clinical Trials as Topic
    Colorectal Neoplasms
    Dietary Supplements
    Folic Acid
    Humans
    Incidence
    Risk Factors
    Vitamin B Complex

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    21177150

    Citation

    Kennedy, Deborah A., et al. "Folate Intake and the Risk of Colorectal Cancer: a Systematic Review and Meta-analysis." Cancer Epidemiology, vol. 35, no. 1, 2011, pp. 2-10.
    Kennedy DA, Stern SJ, Moretti M, et al. Folate intake and the risk of colorectal cancer: a systematic review and meta-analysis. Cancer Epidemiol. 2011;35(1):2-10.
    Kennedy, D. A., Stern, S. J., Moretti, M., Matok, I., Sarkar, M., Nickel, C., & Koren, G. (2011). Folate intake and the risk of colorectal cancer: a systematic review and meta-analysis. Cancer Epidemiology, 35(1), pp. 2-10. doi:10.1016/j.canep.2010.11.004.
    Kennedy DA, et al. Folate Intake and the Risk of Colorectal Cancer: a Systematic Review and Meta-analysis. Cancer Epidemiol. 2011;35(1):2-10. PubMed PMID: 21177150.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Folate intake and the risk of colorectal cancer: a systematic review and meta-analysis. AU - Kennedy,Deborah A, AU - Stern,Seth J, AU - Moretti,Myla, AU - Matok,Ilan, AU - Sarkar,Moumita, AU - Nickel,Cheri, AU - Koren,Gideon, Y1 - 2010/12/21/ PY - 2010/08/08/received PY - 2010/11/04/revised PY - 2010/11/17/accepted PY - 2010/12/24/entrez PY - 2010/12/24/pubmed PY - 2011/6/1/medline SP - 2 EP - 10 JF - Cancer epidemiology JO - Cancer Epidemiol VL - 35 IS - 1 N2 - INTRODUCTION: Folic acid fortification and supplementation to prevent neural tube defects has led to concerns regarding increased risk of colorectal cancer. The results of existing studies have been inconclusive. The purpose was to examine the relationship between level of folate intake and the incidence of colorectal cancer. METHODS: A systematic review and meta analysis were conducted. MEDLINE, Embase, and SCOPUS were searched from inception to October 2009 with the following search terms "folic acid," "folate", "colorectal cancer," "colon neoplasms," rectal neoplasms." Observational studies in adult populations were included that defined levels of folate intake and incidence of colorectal cancer. RESULT: Out of 6427 references, 27 studies met our inclusion criteria. The summary risk estimate for case control studies comparing high versus low total folate intake was 0.85 (CI 95% 0.74-0.99) with no significant heterogeneity among studies. Similarly, for cohort studies, the resulting summary risk estimate for high versus low dietary folate intake was 0.92 (CI 95% 0.81-1.05) with no significant heterogeneity. However, defining what represents a higher intake of folic acid is difficult as there is variability in the upper limit of folic acid intake used in the studies. DISCUSSION: These results suggest that higher folate intake levels offer a reduction in one of the perceived risks associated with developing colorectal cancer. These data can serve to help reassure women planning a pregnancy to increase folic intake during the preconception period to levels sufficient to prevent neural tube defects. SN - 1877-783X UR - https://www.unboundmedicine.com/medline/citation/21177150/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1877-7821(10)00204-3 DB - PRIME DP - Unbound Medicine ER -