Case control study of periconceptional folic acid intake and nervous system tumors in children
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Since 1992, the Centers for Disease Control and Prevention recommends that women of childbearing age consume 400 µg of folic acid per day to reduce the risk of neural tube defects (NTD). It has been speculated that both NTD and nervous system tumors (NST) may share common mechanisms of altered development. It examines the association between folic acid supplementation and the risk for childhood NST.
Incident cases of children with cancer in Spain registered between 2004 and 2006 were identified through the MACAPE Network Group. Tumors were classified as tumors derived from the neuroectoderm (cases) and those with a mesoderm origin (controls). In a second analysis, NST were further divided into central nervous system tumors (CNST) and sympathetic nervous system tumors (SNST). We compared folic acid supplementation between the groups.
Overall, folic acid supplementation any time during pregnancy was similar between cases and controls (odds ratio (OR) = 1.05; 95% confidence interval (CI) 0.92–1.20). However, supplementation before the 21st and 36th days of gestation resulted in significantly lower NST than in children with mesoderm tumors (OR = 0.34; 95% CI 0.17–0.69 and OR = 0.58; 95% CI 0.37–0.91, respectively). Preconceptional intakes of folic acid were also lower in NST although marginally nonsignificant (OR = 0.44; 95% CI 0.10–1.02). When NST were divided into CNST and SNST, significant differences between tumors of mesoderm origin were only found for CNST.
Our results support the hypothesis that folate supplementation reduces the risk of childhood NST, especially CNST. The specific mechanism and cellular role that folate may play in the development of CNST have yet to be elucidated.
KeywordsFolic acid Folate supplementation Pediatric cancer Nervous system tumors
The authors express their gratitude for the support and funding granted by the Scientific Foundation of the AECC (Asociación Española Contra el Cáncer). Additionally, we thank Isaedmarie Fevo and Rayden Llano from the Mount Sinai International Exchange Program for Minority Students. Their work is supported by grant MD001452 from the National Center on Minority Health and Health Disparities of the National Institutes of Health.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Center Disease Control (CDC) (1992) Recommendations for the use of folic acid to reduce the number of cases of spine bifida and other neural tube defects. MMWR 41(No. RR-14):1–7Google Scholar
- 3.Giovarmucci E, Stampfer MJ, Coldlitz GA, Hunter DJ, Fuchs C, Rosner BA, Speizer FE, Willett WC (1998) Multivitamin use, folate, and colon cancer in women in the Nurse’s Health Study. Ann Intern Med 129:517–534Google Scholar
- 8.Sirachainan N, Wongruangsri S, Kajanachumpol S, Pakakasama S, Visudtibhan A, Nuchprayoon I, Lusawat A, Phudhicharoenrat S, Shuangshoti S, Hongeng S (2008) Folate pathway genetic polymorphisms and susceptibility of central nervous system tumors in Thai children. Cancer Detect Prev 32:72–78CrossRefPubMedGoogle Scholar
- 17.Preston-Martin S, Pogoda JM, Mueller BA, Lubin F, Modan B, Holly EA, Filippini G, Cordier S, Peris-Bonet R, Choi W, Little J, Arslan A (1998) Results from an international case-control study of childhood brain tumors: the role of prenatal vitamin supplementation. Environ Health Perspect 106:887–892CrossRefPubMedGoogle Scholar
- 19.Ries LAG, Smith MA, Gurney JG, Linet M, Tamra T, Young JL et al (1999) Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975–1995, National Cancer Institute, SEER Program NIH Pub No. 99–4649. BetshedaGoogle Scholar
- 20.Ortega García JA, Martin M, López Fernández MT, Fuster Soler JL, Donat-Colomer J, López-Ibor B, Claudio L, Ferrís-Tortajada J (2010) Transgenerational tobacco smoke exposure and childhood cancer: an observational study (In press) doi: 10.1111/j.1440-1754.2010.01710.x
- 21.Ries LAG, Smith MA, Gurney JG et al (eds) (1999) Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975–1995. National Cancer Institute, SEER Program NIG Pub No, Bethesda, pp 99–4649Google Scholar