Dietary Folate Tied to Reduced Risk of Pancreatic Cancer
Increased consumption of folate from dietary sources, but not from
supplements, appears to reduce the risk of exocrine pancreatic cancer,
according to results of a large population-based prospective study of
Swedish men and women.
Previous epidemiological studies have suggested a protective role of folate
against colorectal and breast cancer, Dr. Susanna C. Larsson and colleagues
note in their report, published in the Journal of the National Cancer
Institute for March 15.
To see if folate protects against pancreatic cancer too, Dr. Larsson, from
Karolinska Institute in Stockholm, and her group prospectively followed
subjects in the Swedish Mammography Cohort and the Cohort of Swedish Men.
Included were 36,616 women and 45,306 men ages 45 to 83 years old in 1997,
when they completed food frequency questionnaires.
During an average of 6.8 years of follow-up, there were 135 incident cases
of exocrine pancreatic cancer. The investigators performed multivariable
analyses adjusting for demographics, smoking, BMI, diabetes, exercise, and
intake of fruits, vegetables, calories, carbohydrates, and alcohol.
For subjects in the highest quintile of dietary folate intake (350 g/day or
higher), the adjusted rate ratio for pancreatic cancer was 0.25 compared
with those in the lowest quintile (< 200 g/day), (p for trend = 0.002).
However, there was no association between folic acid from supplements and
pancreatic cancer risk (rate ratio for folate supplementation of 300 g/day
or more versus 0 g/day = 1.02).
Dr. Larsson's group theorizes that the reason that dietary folate alone
reduced the risk of pancreatic cancer may be that folate from food sources
better represents long-term folate intake than does folate from supplements.
Another possibility suggested by animal studies of high folic acid
supplementation is that high intake of folate from supplements may promote
the progression of cancer when it already exists in an individual.
"Although our results suggest that increased consumption of foods naturally
rich in folate may be beneficial," the authors conclude, "they do not
encourage increased use of supplements for the prevention of pancreatic
cancer."
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