Folic acid supplementation inhibits recurrence of colorectal adenomas： A randomized chemoprevention trial

• Published in: World journal of gastroenterology : WJG 2008-07, Vol.14 (28), p.4492-4498
• Main Authors: Jaszewski, Richard, Misra, Sabeena, Tobi, Martin, Ullah, Nadeem, Naumoff, Jo Ann, Kucuk, Omer, Levi, Edi, Axelrod, Bradley N, Patel, Bhaumik B, Majumdar, Adhip P N
• Format: Article
• Language: English
• Subjects: Adenoma - prevention & control; Aged; Colonoscopy; Colorectal Neoplasms - prevention & control; Dietary Supplements; Dose-Response Relationship, Drug; Double-Blind Method; Female; Folic Acid - therapeutic use; Follow-Up Studies; Humans; Longitudinal Studies; Male; Middle Aged; Neoplasm Recurrence, Local - prevention & control; Rapid Communication; Risk Factors; Treatment Outcome; 循环障碍; 抑制剂; 结肠直肠癌
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.14.4492

AIM： To determine whether folic acid supplementation will reduce the recurrence of colorectal adenomas, the precursors of colorectal cancer, we performed a double-blind placebo-controlled trial in patients with adenomatous polyps. METHODS： In the current double-blind, placebocontrolled trial at this VA Medical Center, patients with colorectal adenomas were randomly assigned to receive either a daily 5 mg dose of folic acid or a matched identical placebo for 3 years. All polyps were removed at baseline colonoscopy and each patient had a follow up colonoscopy at 3 years. The primary endpoint was a reduction in the number of recurrent adenomas at 3 years. RESULTS： Of 137 subjects, who were eligible after confirmation of polyp histology and run-in period to conform compliance, 94 completed the study; 49 in folic acid group and 45 in placebo group. Recurrence of adenomas at 3-year was compared between the two groups. The mean number of recurrent polyps at 3-year was 0.36 （SD, 0.69） for folic acid treated patients compared to 0.82 （SD, 1.17） for placebo treated subjects, resulting in a 3-fold increase in polyp recurrence in the placebo group. Patients below 70 years of age and those with left-sided colonic adenomas or advanced adenomas responded better to folic acid supplementation. CONCLUSION： High dose folic acid supplementation is associated with a significant reduction in the recurrence of colonic adenomas suggesting that folic acid may be an effective chemopreventive agent for colorectal neoplasia.