title: Folate intake, post-folic acid grain fortification, and pancreatic cancer risk in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.
abstract: BACKGROUND
  Folate plays a critical role in DNA methylation, synthesis, and repair. Several epidemiologic studies suggest that higher folate intake is associated with decreased pancreatic cancer risk.
  
  
  OBJECTIVE
  We investigated the association between dietary folate intake and pancreatic cancer in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort.
  
  
  METHODS
  Dietary data were collected with the use of a self-administered food-frequency questionnaire (1998-2005). Among the 51,988 male and 57,187 female participants, aged 55-74 y at enrollment, with complete dietary and multivitamin information, 162 men and 104 women developed pancreatic cancer during follow-up (January 1998 to December 2006; median: 6.5 y). We used Cox proportional hazards regression with age as the time metric to calculate hazard ratios (HRs) and 95% CIs.
  
  
  RESULTS
  The highest compared with the lowest quartile of food folate was associated with a significantly decreased pancreatic cancer risk among women (> or = 253.3 compared with < or = 179.1 microg/d; HR = 0.47; 95% CI: 0.23, 0.94; P for trend: 0.09) but not among men (> or = 229.6 compared with < or = 158.0 microg/d; HR = 1.20; 95% CI: 0.70, 2.04; P for trend: 0.67; P for interaction by sex: 0.03). There was also a significant inverse trend in risk of pancreatic cancer across increasing quartiles of total folate in women (P for trend: 0.04) but not in men (P for trend: 0.65). Folic acid supplements were not associated with pancreatic cancer.
  
  
  CONCLUSIONS
  These findings support an association between higher food and total folate intakes and decreased risk of pancreatic cancer in women but not in men.
authors.affiliation: Nutritional Epidemiology Branch, the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA. boaks@ucdavis.edu
authors.forename: Brietta M
authors.initials: BM
authors.lastname: Oaks
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Dodd
authors.forename: Cari L
authors.initials: CL
authors.lastname: Meinhold
authors.forename: Li
authors.initials: L
authors.lastname: Jiao
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Church
authors.forename: Rachael Z
authors.initials: RZ
authors.lastname: Stolzenberg-Solomon
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000517:prevention & control; D000368:Aged; D015331:Cohort Studies; D004435:Eating / Q000502:physiology*; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005527:Food, Fortified; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D016016:Proportional Hazards Models; D012737:Sex Factors; D011795:Surveys and Questionnaires
chemical_list: D005492:Folic Acid