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Pooled analyses of 13 prospective cohort studies on folate intake and colon cancer.
Kim, DH, Smith-Warner, SA, Spiegelman, D, Yaun, SS, Colditz, GA, Freudenheim, JL, Giovannucci, E, Goldbohm, RA, Graham, S, Harnack, L, et al
Cancer causes & control : CCC. 2010;(11):1919-30
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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.