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Pooled analyses of 13 prospective cohort studies on folate intake and colon cancer

Cancer Causes & Control volume 21, pages 1919–1930 (2010)Cite this article

Abstract

Objective

Studies of folate intake and colorectal cancer risk have been inconsistent. We examined the relation with colon cancer risk in a series of 13 prospective studies.

Methods

Study- and sex-specific relative risks (RRs) were estimated from the primary data using Cox proportional hazards models and then pooled using a random-effects model.

Results

Among 725,134 participants, 5,720 incident colon cancers were diagnosed during follow-up. The pooled multivariate RRs (95% confidence interval [CI]) comparing the highest vs. lowest quintile of intake were 0.92 (95% CI 0.84–1.00, p-value, test for between-studies heterogeneity = 0.85) for dietary folate and 0.85 (95% CI 0.77–0.95, p-value, test for between-studies heterogeneity = 0.42) for total folate. Results for total folate intake were similar in analyses using absolute intake cutpoints (pooled multivariate RR = 0.87, 95% CI 0.78–0.98, comparing ≥560 mcg/days vs. <240 mcg/days, p-value, test for trend = 0.009). When analyzed as a continuous variable, a 2% risk reduction (95% CI 0–3%) was estimated for every 100 μg/day increase in total folate intake.

Conclusion

These data support the hypothesis that higher folate intake is modestly associated with reduced risk of colon cancer.

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Acknowledgments

Supported by research grant CA55075 from the National Institutes of Health and by the National Colorectal Cancer Research Alliance.

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Affiliations

  1. Department of Social and Preventive Medicine, College of Medicine, Hallym University, Chunchon, Korea

    Dong-Hyun Kim

  2. Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA, 02115, USA

    Stephanie A. Smith-Warner, Shiaw-Shyuan Yaun, Edward Giovannucci, Walter C. Willett & David J. Hunter

  3. Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

    Stephanie A. Smith-Warner, Donna Spiegelman, Edward Giovannucci, Walter C. Willett & David J. Hunter

  4. Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Donna Spiegelman

  5. Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA

    Frank E. Speizer

  6. Institute for Public Health, Washington University School of Medicine, St. Louis, MO, USA

    Graham A. Colditz

  7. Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Edward Giovannucci, Frank E. Speizer, Walter C. Willett & David J. Hunter

  8. Department of Social and Preventive Medicine, University at Buffalo, State University of New York, Buffalo, NY, USA

    Jo L. Freudenheim & Saxon Graham

  9. Department of Prevention and Health, TNO Quality of Life, Leiden, The Netherlands

    R. Alexandra Goldbohm

  10. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    Lisa Harnack

  11. Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA, USA

    Eric J. Jacobs & Victoria L. Stevens

  12. Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany

    Michael Leitzmann

  13. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA

    Arthur Schatzkin

  14. Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA

    Rachael Stolzenberg-Solomon

  15. Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland

    Satu Mannisto

  16. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Anthony B. Miller

  17. Division of Public Health Services, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    John D. Potter

  18. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Thomas E. Rohan

  19. Department of Epidemiology, Emory University, Rollins School of Public Health, Atlanta, GA, USA

    Paul Terry

  20. Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands

    Matty P. Weijenberg

  21. Division of Nutritional Epidemiology, The National Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden

    Alicja Wolk

  22. Department of Environmental Medicine, New York University, New York, NY, USA

    Paolo Toniolo & Anne Zeleniuch-Jacquotte

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  1. Dong-Hyun Kim
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  2. Stephanie A. Smith-Warner
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  18. Frank E. Speizer
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  19. Victoria L. Stevens
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  21. Paul Terry
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  25. Alicja Wolk
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  26. Anne Zeleniuch-Jacquotte
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  27. David J. Hunter
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Correspondence to Stephanie A. Smith-Warner.

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Kim, DH., Smith-Warner, S.A., Spiegelman, D. et al. Pooled analyses of 13 prospective cohort studies on folate intake and colon cancer. Cancer Causes Control 21, 1919–1930 (2010). https://doi.org/10.1007/s10552-010-9620-8

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  • DOI: https://doi.org/10.1007/s10552-010-9620-8

Keywords

  • Colon cancer
  • Folate
  • Cohort studies
  • Meta-analysis
  • Pooled analysis