Folic acid supplementation and cancer risk: A meta-analysis of randomized controlled trials

Xianhui Qin, Yimin Cui, Lin Shen, Ningling Sun, Yan Zhang, Jianping Li, Xin Xu, Binyan Wang, Xiping Xu, Yong Huo, Xiaobin Wang

Research output: Contribution to journalReview article

Abstract

There are growing data and a continuing controversy over the effect of folic acid supplementation on cancer risk. We conducted a meta-analysis based on up-to-date published relevant randomized trials to further examine this issue. Relative risk (RR) was used to measure the effect of folic acid supplementation on risk of cancer using a random-effects model. Overall, folic acid supplementation had no significant effect on total cancer incidence (13 trials, n = 49,406, RR = 1.05; 95% CI: 0.99-1.11, p = 0.13), colorectal cancer (seven trials, n = 33,824, 1.01; 0.82-1.23, p = 0.95), other gastrointestinal cancer (two trials, n = 20,228, 1.00; 0.75-1.33, p = 0.99), prostate cancer (five trials, n = 27,065, 1.17; 0.84-1.62, p = 0.35), other genitourinary cancer (two trials, n = 20,228, 0.97; 0.75-1.27, p = 0.84), lung cancer (five trials, n = 31,864, 1.00; 0.84-1.21, p = 0.97), breast cancer (four trials, n = 19,800, 0.82; 0.63-1.07, p = 0.15), hematological malignancy (three trials, n = 25,670, 0.87; 0.64-1.17, p = 0.35) and total cancer mortality (six trials, n = 31,930, 1.02; 0.90-1.15, p = 0.81). However, a significantly reduced risk was observed for melanoma (three trials, n = 19,128, 0.47; 0.23-0.94, p = 0.03). Furthermore, higher total cancer incidence risk was observed among those trials with a higher percent use of lipid-lowering drugs (>60%, 1.10; 1.00-1.20, p = 0.04), or with lower percent baseline hypertension (≤70%, 1.08; 1.00-1.16, p = 0.057).Consistently, meta-regression analyses suggested that the similar trend between percent use of lipid-lowering drugs (p = 0.084) or percent baseline hypertension (p = 0.056) and log-RR for total cancer incidence associated with folic acid supplementation. Our findings indicate that folic acid supplementation has no significant effect on total cancer incidence, colorectal cancer, prostate cancer, lung cancer, breast cancer or hematological malignancy, but reduces the risk of melanoma.

Original languageEnglish (US)
Pages (from-to)1033-1041
Number of pages9
JournalInternational Journal of Cancer
Volume133
Issue number5
DOIs
StatePublished - Sep 1 2013

Keywords

  • cancer risk
  • folic acid supplementation
  • meta-analysis
  • randomized controlled trials

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Qin, X., Cui, Y., Shen, L., Sun, N., Zhang, Y., Li, J., Xu, X., Wang, B., Xu, X., Huo, Y., & Wang, X. (2013). Folic acid supplementation and cancer risk: A meta-analysis of randomized controlled trials. International Journal of Cancer, 133(5), 1033-1041. https://doi.org/10.1002/ijc.28038