title: Opposing roles of folate in prostate cancer.
abstract: The US diet has been fortified with folic acid to prevent neural tube defects since 1998. The Physician Data Queries from the National Cancer Institute describe folate as protective against prostate cancer, whereas its synthetic analog, folic acid, is considered to increase prostate cancer risk when taken at levels easily achievable by eating fortified food or taking over-the-counter supplements. We review the present literature to examine the effects of folate and folic acid on prostate cancer, help interpret previous epidemiologic data, and provide clarification regarding the apparently opposing roles of folate for patients with prostate cancer. A literature search was conducted in Medline to identify studies investigating the effect of nutrition and specifically folate and folic acid on prostate carcinogenesis and progression. In addition, the National Health and Nutrition Examination Survey database was analyzed for trends in serum folate levels before and after mandatory fortification. Folate likely plays a dual role in prostate carcinogenesis. There remains conflicting epidemiologic evidence regarding folate and prostate cancer risk; however, there is growing experimental evidence that higher circulating folate levels can contribute to prostate cancer progression. Further research is needed to clarify these complex relationships.
authors.affiliation: Department of Urology, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Rycyna
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Bacich
authors.forename: Denise S
authors.initials: DS
authors.lastname: O'Keefe
mesh_terms: D000818:Animals; D063646:Carcinogenesis / Q000235:genetics / Q000378:metabolism; D045744:Cell Line, Tumor / Q000378:metabolism; D018450:Disease Progression; D005492:Folic Acid / Q000097:blood / Q000502:physiology; D005494:Folic Acid Deficiency / Q000453:epidemiology; D006801:Humans; D007150:Immunohistochemistry; D007610:Kallikreins / Q000378:metabolism / Q000502:physiology; D008297:Male; D009749:Nutrition Surveys; D017430:Prostate-Specific Antigen / Q000378:metabolism / Q000502:physiology; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D014803:Vitamin B Complex / Q000502:physiology
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen