Colon cancer and the relationship with folic acid fortification
DOI:
https://doi.org/10.14306/renhyd.20.3.191Keywords:
Colonic Neoplasms, Colorectal Neoplasms, Folic Acid, Food, FortifiedAbstract
The fortification of flour baking in Chile with folic acid in pregnant women significantly reduced the neural tube defects, however this situation also affects the rest of the population. What about supplementation in children, adults and adults older that do not require an extra intake of folic acid? Relate folic acid fortification with the risk of developing colon cancer is the aim of this review. Some meta-analyzes indicate that folate supplementation does not increase long-term relative risk and incidence of colorectal cancer, however other relevant studies indicate this relationship to estimate feasible because the evidence is inconclusive. The available evidence shows conflicting results; depending on the methodological study design, source of folate, fortification dose and duration of this addition to the target population; so these features should be considered in the analysis of the risk of developing colorectal cancer. It should be considered that the evidence is inconclusive regarding folate supplementation and the risk of developing colorectal cancer. Evidence indicates that the relationship is dependent on dose and time of administration, methodological design, geographical location of the study, subject ethnicity, and other variables such as lifestyle may have influenced some studies. It is recommended to analyze future studies locally and follow carefully the incidence of colorectal cancer and relate national program development folic acid fortification.References
(1) Ministerio de Salud, Gobierno de Chile. Norma Técnica para la Fortificación de la Harina de Trigo con Vitaminas y Minerales. 1999 p. 1-23.
(2) Ministerio de Salud, Gobierno de Chile. Decreto Supremo N° 977/96 – Reglamento Sanitario de los Alimentos. 1996 p. 1-193.
(3) Espinosa JF. Sisvan de alimentos índices. Santiago, Chile: INTA; 1996.
(4) Hertrampf E, Cortés F. National food-fortification program with folic acid in Chile. Food Nutr Bull. 2008; 29(2 Suppl): S231-7.
(5) Llanos A, Hertrampf E, Cortes F, Pardo A, Grosse SD, Uauy R. Cost-effectiveness of a folic acid fortification program in Chile. Health Policy. 2007; 83(2-3): 295-303.
(6) Castillo C, Tur JA, Uauy R. Fortificación de la harina de trigo con ácido fólico en Chile: Consecuencias no intencionadas. Rev Med Chile. 2010; 138(7): 832-40.
(7) Hirsch S, Ronco AM, Guerrero-Bosagna C, de la Maza MP, Leiva L, Barrera G, et al. Methylation status in healthy subjects with normal and high serum folate concentration. Nutrition. 2008; 24(11-12): 1103-9.
(8) Terry P, Jain M, Miller AB, Howe GR, Rohan TE. Dietary intake of folic acid and colorectal cancer risk in a cohort of women. Int J Cancer. 2002; 97(6): 864-7.
(9) Ibrahim EM, Zekri JM. Folic acid supplementation for the prevention of recurrence of colorectal adenomas: metaanalysis of interventional trials. Med Oncol. 2010; 27(3): 915-8.
(10) Castillo-Lancellotti C, Tur Marí JA, Uauy Dagach R. Suplementación con ácido fólico y prevención de recurrencia de adenomas colorrectales; revisión sistemática. Nutr Hosp. 2012; 27(1): 13-21.
(11) Qin X, Cui Y, Shen L, Sun N, Zhang Y, Li J, et al. Folic acid supplementation and cancer risk: a meta-analysis of randomized controlled trials. Int J Cancer. 2013; 133(5): 1033-41.
(12) Figueiredo JC, Mott LA, Giovannucci E, Wu K, Cole B, Grainge MJ, et al. Folic acid and prevention of colorectal adenomas: a combined analysis of randomized clinical trials. Int J Cancer. 2011; 129(1): 192-203.
(13) Little J. Multivitamins, folate, and colon cancer. Gut. 2001; 48(1): 12-3.
(14) Sanjoaquin MA, Allen N, Couto E, Roddam AW, Key TJ. Folate intake and colorectal cancer risk: a meta-analytical approach. Int J Cancer. 2005; 113(5): 825-8.
(15) Glynn SA, Albanes D, Pietinen P, Brown CC, Rautalahti M, Tangrea JA, et al. Colorectal cancer and folate status: a nested case-control study among male smokers. Cancer Epidemiol Biomarkers Prev. 1996; 5(7): 487-94.
(16) Mason JB, Dickstein A, Jacques PF, Haggarty P, Selhub J, Dallal G, et al. A temporal association between folic acid fortification and an increase in colorectal cancer rates may be illuminating important biological principles: a hypothesis. Cancer Epidemiol Biomarkers Prev. 2007; 16(7): 1325-9.
(17) Jaszewski R, Misra S, Tobi M, Ullah N, Naumoff JA, Kucuk O, et al. Folic acid supplementation inhibits recurrence of colorectal adenomas: a randomized chemoprevention trial. World J Gastroenterol. 2008; 14(28): 4492-8.
(18) Fife J, Raniga S, Hider PN, Frizelle FA. Folic acid supplementation and colorectal cancer risk: a meta-analysis. Colorectal Dis. 2011; 13(2): 132-7.
(19) Heine-Bröring RC, Winkels RM, Renkema JMS, Kragt L, van Orten-Luiten A-CB, Tigchelaar EF, et al. Dietary supplement use and colorectal cancer risk: a systematic review and metaanalyses of prospective cohort studies. Int J Cancer. 2015; 136(10): 2388-401.
(20) Qin T, Du M, Du H, Shu Y, Wang M, Zhu L. Folic acid supplements and colorectal cancer risk: meta-analysis of randomized controlled trials. Sci Rep. 2015; 5: 12044.
(21) Vollset SE, Clarke R, Lewington S, Ebbing M, Halsey J, Lonn E, et al. Effects of folic acid supplementation on overall and site-specific cancer incidence during the randomised trials: meta-analyses of data on 50,000 individuals. Lancet. 2013; 381(9871): 1029-36.
(22) Kennedy DA, Stern SJ, Matok I, Moretti ME, Sarkar M, Adams-Webber T, et al. Folate Intake, MTHFR Polymorphisms, and the Risk of Colorectal Cancer: A Systematic Review and Meta-Analysis. J Cancer Epidemiol. 2012; 2012: 952508.
(23) Yang Z, Zhang X-F, Liu H-X, Hao Y-S, Zhao C-L. MTHFR C677T polymorphism and colorectal cancer risk in Asians, a metaanalysis of 21 studies. Asian Pac J Cancer Prev. 2012; 13(4): 1203-8.
(24) Pabalan N, Jarjanazi H, Ozcelik H. A meta-analysis of the C1420T polymorphism in cytosolic serine hydroxymethyltransferase (SHMT1) among Caucasian colorectal cancer populations. Int J Colorectal Dis. 2013; 28(7): 925-32.
(25) Lin HL, An QZ, Wang QZ, Liu CX. Folate intake and pancreatic cancer risk: an overall and dose-response meta-analysis. Public Health. 2013;127(7):607-13.
(26) Wang R, Zheng Y, Huang J-Y, Zhang A-Q, Zhou Y-H, Wang J-N. Folate intake, serum folate levels, and prostate cancer risk: a meta-analysis of prospective studies. BMC Public Health. 2014; 14: 1326.
(27) Tio M, Andrici J, Cox MR, Eslick GD. Folate intake and the risk of prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2014; 17(3): 213-9.
(28) Galeone C, Edefonti V, Parpinel M, Leoncini E, Matsuo K, Talamini R, et al. Folate intake and the risk of oral cavity and pharyngeal cancer: a pooled analysis within the International Head and Neck Cancer Epidemiology Consortium. Int J Cancer. 2015; 136(4): 904-14.
(29) Zhang Y-F, Shi W-W, Gao H-F, Zhou L, Hou A-J, Zhou Y-H. Folate intake and the risk of breast cancer: a dose-response meta-analysis of prospective studies. PLoS ONE. 2014; 9(6): e100044.
(30) Li B, Lu Y, Wang L, Zhang C-X. Folate intake and breast cancer prognosis: a meta-analysis of prospective observational studies. Eur J Cancer Prev. 2015; 24(2): 113-21.
(31) Tio M, Andrici J, Eslick GD. Folate intake and the risk of breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat. 2014; 145(2): 513-24.
(32) Liu M, Cui L-H, Ma A-G, Li N, Piao J-M. Lack of effects of dietary folate intake on risk of breast cancer: an updated metaanalysis of prospective studies. Asian Pac J Cancer Prev. 2014; 15(5): 2323-8.
(33) Chen P, Li C, Li X, Li J, Chu R, Wang H. Higher dietary folate intake reduces the breast cancer risk: a systematic review and meta-analysis. Br J Cancer. 2014; 110(9): 2327-38.
(34) Zhang Y-F, Zhou L, Zhang H-W, Hou A-J, Gao H-F, Zhou Y-H. Association between folate intake and the risk of lung cancer: a dose-response meta-analysis of prospective studies. PLoS ONE. 2014; 9(4): e93465.
(35) Dai W-M, Yang B, Chu X-Y, Wang Y-Q, Zhao M, Chen L, et al. Association between folate intake, serum folate levels and the risk of lung cancer: a systematic review and meta-analysis. Chin Med J. 2013; 126(10): 1957-64.
(36) He H, Shui B. Folate intake and risk of bladder cancer: a metaanalysis of epidemiological studies. Int J Food Sci Nutr. 2014; 65(3): 286-92.
(37) Tio M, Andrici J, Cox MR, Eslick GD. Folate intake and the risk of upper gastrointestinal cancers: a systematic review and metaanalysis. J Gastroenterol Hepatol. 2014; 29(2): 250-8.