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Cancer risk with folic acid supplements: a systematic review and meta-analysis
Tale Norbye Wien1, Eva Pike, Torbjørn Wisløff
1Norwegian Knowledge Centre for the Health Services, Oslo, Norway.
BMJ Open
|January 14, 2012
Summary
Oral folic acid supplements showed a borderline significant increase in overall cancer risk. Prostate cancer incidence was notably higher in men taking folic acid, but total cancer mortality did not differ significantly.
Area of Science:
- Oncology
- Nutritional Science
- Epidemiology
Background:
- Folic acid is essential for cell growth and DNA synthesis.
- Concerns exist regarding potential adverse effects of high-dose folic acid supplementation.
- Understanding the relationship between folic acid intake and cancer risk is crucial for public health.
Purpose of the Study:
- To systematically review and meta-analyze controlled human studies on oral folic acid supplementation and cancer risk.
- To investigate the association between folic acid supplements and overall cancer incidence, specific cancer types, and cancer mortality.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies.
- Searched major databases including Cochrane Library, Medline, and Embase.
- Included studies reporting cancer incidence and/or mortality in individuals receiving folic acid supplements.
Main Results:
- Meta-analysis of 10 RCTs (N=38,233) indicated a borderline significant increase in overall cancer incidence (RR 1.07, 95% CI 1.00-1.14).
- Meta-analyses of six RCTs revealed a significant increase in prostate cancer incidence (RR 1.24, 95% CI 1.03-1.49) with folic acid supplementation.
- No significant differences in incidence were observed for other cancer types, nor in total cancer mortality.
Conclusions:
- Oral folic acid supplementation may be associated with a slight increase in overall cancer risk.
- Prostate cancer appears to be the only cancer type with a statistically significant increased incidence linked to folic acid supplements.
- Further research on folic acid fortification and its impact on prostate cancer risk is warranted.
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