Intake of dietary folate vitamers and risk of colorectal carcinoma

Results from The Netherlands Cohort Study

Authors

  • Erik J. M. Konings Ph.D.,

    Corresponding author
    1. Inspectorate for Health Protection and Veterinary Public Health, 's-Hertogenbosch, The Netherlands
    2. Nutrition and Toxicology Research Institute NUTRIM, Maastricht University, Maastricht, The Netherlands
    • Inspectorate for Health Protection and Veterinary Public Health, P.O. Box 2280, 5202 CG ‘s-Hertogenbosch, The Netherlands
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    • Fax: +31402911600

  • R. Alexandra Goldbohm Ph.D.,

    1. Department of Nutritional Epidemiology, TNO Nutrition and Food Research, Zeist, The Netherlands
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  • Henny A. M. Brants,

    1. Department of Nutritional Epidemiology, TNO Nutrition and Food Research, Zeist, The Netherlands
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  • Wim H. M. Saris M.D., Ph.D.,

    1. Nutrition and Toxicology Research Institute NUTRIM, Maastricht University, Maastricht, The Netherlands
    2. Department of Human Biology, Maastricht University, Maastricht, The Netherlands
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  • Piet A. van den Brandt Ph.D.

    1. Nutrition and Toxicology Research Institute NUTRIM, Maastricht University, Maastricht, The Netherlands
    2. Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
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Abstract

BACKGROUND

Several studies have reported inverse associations between folate intake and colorectal carcinoma risk. Few were prospective studies and none evaluated the association between the intake of individual folate vitamers and colorectal carcinoma risk.

METHODS

The aim of the current study was to investigate the relationship between dietary folate intake and the risk of colorectal carcinoma in a large prospective cohort study in The Netherlands comprising 120,852 men and women aged 55–69 years. After 7.3 years of follow-up, 760 colon and 411 rectal carcinoma cases were available for analysis. Data processing and analysis used the case–cohort approach. A new Dutch database was used to estimate intakes of total and individual folate vitamers.

RESULTS

Analyses adjusted for age, energy intake, family history of colorectal carcinoma, alcohol, vitamin C, iron, and dietary fiber intake yielded an inverse association between colon carcinoma risk and total dietary folate intake (rate ratio [RR]highest vs. lowest quintile, men: 0.73; 95% confidence interval [CI], 0.46–1.17, P trend = 0.03; women: 0.68; 95% CI, 0.39–1.20, P trend = 0.18). An inverse association between rectal carcinoma and total dietary folate intake was found only among men (RR highest vs. lowest quintile, men: 0.66; 95% CI, 0.35–1.21, P trend = 0.03). Analyses showed no clear difference in colorectal carcinoma risk associated with intake of different folate vitamers.

CONCLUSIONS

Dietary folate intake was related inversely to colon and male rectal carcinoma risk. Cancer 2002;95:1421–33. © 2002 American Cancer Society.

DOI 10.1002/cncr.10866

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