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Folate intake and the risk of colorectal cancer in a Korean population

European Journal of Clinical Nutrition volume 63, pages 1057–1064 (2009)Cite this article

Abstract

Background:

Folate, a water-soluble B vitamin and one of the major micronutrients in vegetables, is known as an essential factor for the de novo biosynthesis of purines and thymidylate, and it plays an important role in DNA synthesis and replication. Thus, folate deficiency results in ineffective DNA synthesis, and has been shown to induce the initiation and progression of colorectal cancer (CRC). Recently, the incidence of CRC in Korea has increased markedly in both men and women; this trend may be related to the adoption of a more ‘westernized’ lifestyle, including dietary habits.

Objective:

A hospital-based case–control study was conducted to examine the relationship between folate intake and the risk of CRC within a Korean population.

Methods:

A total of 596 cases and 509 controls, aged 30−79 years, were recruited from two university hospitals. Site- and sex-specific odds ratios (ORs) were estimated using logistic regression models.

Results:

Cases were more frequently found to have a family history of CRC among first-degree relatives, to consume more alcohol, to be more likely current smokers and less likely to participate in vigorous physical activity than the controls. In the overall data for men and women combined, multivariate ORs (95% confidence interval (CI), P for trend) comparing the highest vs the lowest quartile of dietary folate intake were: 0.47 (0.32–0.69, <0.001) for CRC, 0.42 (0.26–0.69, <0.001) for colon cancer and 0.48 (0.28–0.81, 0.007) for rectal cancer. An inverse association was also found in women with dietary folate intake: 0.36 (0.20–0.64, <0.001) for CRC, 0.34 (0.16–0.70, 0.001) for colon cancer and 0.30 (0.12–0.74, 0.026) for rectal cancer, but not in men. In addition, the total folate intake of women was strongly associated with a reduced risk of rectal cancer (OR, 0.38; 95% CI, 0.17–0.88; P for trend=0.04).

Conclusion:

We found a statistically significant relationship between higher dietary folate intake and reduced risk of CRC, colon cancer and rectal cancer in women. A significant association is indicated between higher total folate intake and reduced risk of rectal cancer in women.

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Acknowledgements

This study was supported by a Grant-in-Aid for Cancer Research on Priority Area from the Ministry of Education, Science, Sports, Culture and Technology of Japan.

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Authors and Affiliations

  1. Cancer Epidemiology Branch, National Cancer Research Institute, National Cancer Center, Goyang, South Korea

    J Kim & S Y Lim

  2. Department of Social and Preventive Medicine, Hallym University College of Medicine, Chunchon, Kangwon-do, South Korea

    D H Kim & Y K Suh

  3. Department of General Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea

    B H Lee

  4. Department of Statistics, Seoul National University, Seoul, South Korea

    S H Kang

  5. Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, South Korea

    H J Lee

  6. Department of Preventive Medicine, Seoul, Seoul National University College of Medicine, Seoul, South Korea

    Y O Ahn

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Correspondence to D H Kim.

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Kim, J., Kim, D., Lee, B. et al. Folate intake and the risk of colorectal cancer in a Korean population. Eur J Clin Nutr 63, 1057–1064 (2009). https://doi.org/10.1038/ejcn.2009.37

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