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Food intake of folate, folic acid and other B vitamins with lung cancer risk in a low-income population in the Southeastern United States

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Abstract

Purpose

We prospectively examined associations of lung cancer risk with food intake of B vitamins involved in one-carbon metabolism and the use of folic acid-containing supplements among a low-income population of black and white adults in the Southeastern US.

Methods

Within the Southern Community Cohort Study, we included 1064 incident lung cancer cases among 68,236 participants aged 40–79 years at study enrollment. Food intake and the use of folic acid-containing supplements were assessed using a validated food frequency questionnaire at study enrollment. Multivariate Cox regression was used to estimate hazards ratios (HRs) and the 95% confidence intervals (CIs).

Results

Folate and/or folic acid intake from food were not associated with lung cancer risk; HRs (95% CI) for highest compared with lowest quartile were 1.08 (0.91–1.29) for total dietary folate, 1.00 (0.84–1.19) for food folate, and 1.09 (0.91–1.30) for food folic acid, respectively. Similarly, no associations were observed after stratifying by sex, race and smoking status, except for a positive association with total dietary folate intake among black women (HR 1.46, 95% CI 1.04–2.05 for the highest quartile compared with the lowest quartile, P trend = 0.02). Neither the use of folic acid-containing supplements nor food intake of vitamin B6, vitamin B12 and riboflavin were associated with lung cancer risk.

Conclusions

Our findings do not support a protective effect of folate or folic acid for lung cancer prevention in a low-income population of black and white adults in the Southeastern US. Our finding of a positive association with total dietary folate intake among black women needs to be interpreted with caution and replicated in other studies.

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Acknowledgements

This study was funded by the National Cancer Institute (Grant numbers: R01 CA092447 and U01CA202979 to W.J. Blot). Data collection was performed by the Survey and Biospecimen Shared Resource, which is supported in part by the Vanderbilt-Ingram Cancer Center (P30CA68485). The authors thank the study participants and research staff of the Southern Community Cohort Study (SCCS) for their contribution to this study. We thank Ms. Nan Kennedy and Dr. Mary Shannon Byers for assistance with editing and manuscript preparation. Data on SCCS cancer cases used in this publication were provided by the Alabama Statewide Cancer Registry; Kentucky Cancer Registry; Tennessee Department of Health, Office of Cancer Surveillance; Florida Cancer Data System; North Carolina Central Cancer Registry, North Carolina Division of Public Health; Georgia Comprehensive Cancer Registry; Louisiana Tumor Registry; Mississippi Cancer Registry; South Carolina Central Cancer Registry; Virginia Department of Health, Virginia Cancer Registry; and Arkansas Department of Health, Cancer Registry. The Arkansas Central Cancer Registry was fully funded by a grant from National Program of Cancer Registries, Centers for Disease Control and Prevention (CDC). Data on SCCS cancer cases from Mississippi were collected by the Mississippi Cancer Registry, which participates in the National Program of Cancer Registries of the CDC. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or the Mississippi Cancer Registry.

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Authors and Affiliations

  1. Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 1161 21st Avenue South, Nashville, TN, 37232, USA

    Yumie Takata, Xiao-Ou Shu, Wanqing Wen, William J. Blot & Qiuyin Cai

  2. College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA

    Yumie Takata

  3. Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine and Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA

    Maciej S. Buchowski

  4. International Epidemiology Field Station, Vanderbilt Institute for Clinical and Translational Research, Rockville, MD, USA

    Heather M. Munro & Mark D. Steinwandel

  5. Department of Internal Medicine, Meharry Medical College, Nashville, TN, USA

    Margaret K. Hargreaves

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  1. Yumie Takata
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  2. Xiao-Ou Shu
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Contributions

WJB and QC designed the study; YT, HMM, WW, and MDS performed statistical analyses; YT drafted the manuscript; X-OS, MSB, WJB, and QC provided critical comments to the draft. QC had primary responsibility for final content. All authors read and approved the final manuscript.

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Correspondence to Qiuyin Cai.

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Takata, Y., Shu, XO., Buchowski, M.S. et al. Food intake of folate, folic acid and other B vitamins with lung cancer risk in a low-income population in the Southeastern United States. Eur J Nutr 59, 671–683 (2020). https://doi.org/10.1007/s00394-019-01934-5

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