The impact of folate intake on the risk of head and neck cancer in the prostate, lung, colorectal, and ovarian cancer screening trial (PLCO) cohort

• Published in: British journal of cancer 2018, Vol.118 (2), p.299-306
• Main Authors: Kawakita, Daisuke, Lee, Yuan-Chin Amy, Gren, Lisa H, Buys, Saundra S, La Vecchia, Carlo, Hashibe, Mia
• Format: Article
• Language: English
• Subjects: 692/4028/67/1536; 692/4028/67/2324; Aged; Alcohols; Biomedical and Life Sciences; Biomedicine; Body mass; Body mass index; Cancer Research; Cancer screening; Cohort Studies; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - epidemiology; Deoxyribonucleic acid; Diet - statistics & numerical data; Dietary intake; DNA; DNA biosynthesis; DNA methylation; DNA repair; Drinking behavior; Drug Resistance; Early Detection of Cancer; Epidemiology; Female; Folic acid; Folic Acid - administration & dosage; Food intake; Food, Fortified - statistics & numerical data; Head & neck cancer; Head and Neck Neoplasms - epidemiology; Health risk assessment; Health risks; Humans; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - epidemiology; Male; Medical screening; Middle Aged; Molecular Medicine; Oncology; Ovarian cancer; Ovarian Neoplasms - diagnosis; Ovarian Neoplasms - epidemiology; Prospective Studies; Prostate; Prostate cancer; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - epidemiology; Smoking; Tobacco; Tobacco smoking; United States - epidemiology; Vitamin B
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2017.383

Background: Although low levels of folate leads to disturbances in DNA replication, DNA methylation and DNA repair, the association between dietary folate intake and head and neck cancer (HNC) risk remains unclear. Methods: We evaluated the association between folate intake and HNC risk using prospective cohort data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. This study included 101 700 participants and 186 cases with confirmed incident HNC. The median follow-up was 12.5 years. We estimated hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) using Cox proportional hazard model including age, sex, body mass index, education, race, tobacco smoking, alcohol drinking and total fruit and vegetable intake. Results: Higher intake of food folate and fortified folic acid in foods was associated with a decreasing HNC risk in a dose–response manner. The HRs of highest vs the lowest quartile of intake were 0.35 (95%CI: 0.18–0.67) for food folate, and 0.49 (95%CI: 0.30–0.82) for fortified folic acid. Intakes of total folate, natural folate and supplemental folic acid were not associated with the risk of HNC and its subsites. We did not detect any interaction between smoking, drinking and food folate intake on HNC risk. Conclusions: These findings provide evidence of the protective role of dietary folate intake on HNC risk.