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

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Author: Kim, D.H. · Smith-Warner, S.A. · Spiegelman, D. · Yaun, S.S. · Colditz, G.A. · Freudenheim, J.L. · Giovannucci, E. · Goldbohm, R.A. · Graham, S. · Harnack, L. · Jacobs, E.J. · Leitzmann, M. · Mannisto, S. · Miller, A.B. · Potter, J.D. · Rohan, T.E. · Schatzkin, A. · Speizer, F.E. · Stevens, V.L. · Stolzenberg-Solomon, R. · Terry, P. · Toniolo, P. · Weijenberg, M.P. · Willett, W.C. · Wolk, A. · Zeleniuch-Jacquotte, A. · Hunter, D.J.
Type:article
Date:2010
Institution: TNO Kwaliteit van Leven
Source:Cancer Causes and Control, 11, 21, 1919-1930
Identifier: 425497
Keywords: Health · Leefomgeving en gezondheid · Cohort studies · Colon cancer · Folate · Meta-analysis · Pooled analysis

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. © 2010 Springer Science+Business Media B.V.