Relationship of Folate to Colorectal and Cervical Cancer: Review and Recommendations for Practitioners

• Published in: Journal of the American Dietetic Association 2002-09, Vol.102 (9), p.1273-1282
• Main Authors: RAMPERSAUD, GAIL C., BAILEY, LYNN B., KAUWELL, GAIL P.A.
• Format: Article
• Language: English
• Subjects: Air. Soil. Water. Waste. Feeding; alcoholic beverages; alcohols; Biological and medical sciences; carcinogenesis; Cervical cancer; clinical trials; Colorectal cancer; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - prevention & control; Confidence Intervals; Diet; DNA; DNA Damage - drug effects; DNA Damage - genetics; DNA methylation; DNA Methylation - drug effects; Environment. Living conditions; Female; Folic acid; Folic Acid - administration & dosage; Fruits; gene expression; Gene Expression Regulation, Neoplastic; genetic polymorphism; Health aspects; Human physiology applied to population studies and life conditions. Human ecophysiology; Humans; Medical sciences; metabolism; nutritional status; Nutritional survey. Food supply and nutritional requirement; observational studies; Odds Ratio; people; Prevention; Public health. Hygiene; Public health. Hygiene-occupational medicine; risk; Risk Factors; uterine cervical neoplasms; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - prevention & control; Vegetables
• ISSN: 0002-8223; 2212-2672; 1878-3570; 2212-2680
• DOI: 10.1016/S0002-8223(02)90281-6

Evidence suggests that folate may play a role in cancer prevention. A plausible mechanism for prevention lies in the integral role that folate plays in deoxyribonucleic acid (DNA) synthesis and methylation. DNA methylation most likely regulates gene expression. Abnormal methylation, specifically hypomethylation, has been associated with tumorigenesis. The availability of methyl groups needed for adequate DNA methylation may be negatively influenced by low folate status, alcohol intake, or genetic polymorphisms that affect folate metabolism. Observational studies evaluating the association between folate and risk for colorectal and cervical cancers or precancerous conditions have produced conflicting results, and clinical trial data are needed to confirm a cause-and-effect relationship. However, several studies show interesting associations between cancer risk and factors that influence methyl group availability. Although data relating folate to cancer risk remain equivocal, when coupled with the other potential health benefits associated with folate, evidence supports recommending that people consume folate-rich foods such as fruits and vegetables. People consuming alcohol on a daily basis may especially benefit from additional folate in their diets. J Am Diet Assoc. 2002;102:1273–1282.