Special report and reviewFolate Intake, MTHFR Polymorphisms, and Risk of Esophageal, Gastric, and Pancreatic Cancer: A Meta-analysis
Section snippets
Study Selection
A computerized literature search was conducted in MEDLINE for studies published in any language from 1966 to March 2006 using the key words folate, folic acid, or MTHFR in combination with cancer, neoplasm, or the individual cancer sites. We also reviewed the reference lists of the relevant articles to identify additional studies. Because folate intake frequently was only one of several dietary factors studied, reports that had fruit, vegetables, vitamins, or nutrients as key words were
Esophageal cancer
We identified 11 case-control studies20, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36 that evaluated the association between dietary folate intake and risk of esophageal cancer. Four studies were excluded for the following reasons: no CIs,33, 34 duplicate publications,35 or the RR was not adjusted by age.36 The 7 remaining studies20, 27, 28, 29, 30, 31, 32 were included in the meta-analysis (Table 1). All studies adjusted for potential confounding by smoking and alcohol intake, and 5 studies also
Discussion
Results of this meta-analysis of observational studies support a significant inverse association of dietary folate intake with risk of esophageal squamous cell carcinoma, esophageal adenocarcinoma, and pancreatic cancer. Summary results indicate that individuals with a high dietary folate intake are about 40%–50% less likely to develop these cancers compared with those with low intake. In support of a role of folate in the etiology of esophageal and pancreatic cancer, most but not all studies
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Supported by the Swedish Research Council/Longitudinal Studies and the Swedish Cancer Foundation.