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JAMA. 1999 May 5;281(17):1632-7.

A prospective study of folate intake and the risk of breast cancer.

Author information

  • 1Department of Epidemiology, Harvard School of Public Health, Boston, Mass, USA. Shumin.Zhang@channing.harvard.edu

Abstract

CONTEXT:

Folate is involved in DNA synthesis and methylation and may reduce breast cancer risk, particularly among women with greater alcohol consumption.

OBJECTIVES:

To assess the association between folate intake and risk of breast cancer and whether higher folate intake may reduce excess risk among women who consume alcohol.

DESIGN:

Prospective cohort study performed in 1980, with 16 years of follow-up.

SETTING AND PARTICIPANTS:

A total of 88818 women who completed the dietary questionnaire section of the Nurses' Health Study in 1980.

MAIN OUTCOME MEASURE:

Incidence of invasive breast cancer by levels of folate and alcohol intake.

RESULTS:

A total of 3483 cases of breast cancer were documented. Total folate intake was not associated with overall risk of breast cancer. However, among women who consumed at least 15 g/d of alcohol, the risk of breast cancer was highest among those with low folate intake. For total folate intake of at least 600 microg/d compared with 150 to 299 microg/d, the multivariate relative risk (RR) was 0.55 (95% confidence interval [CI], 0.39-0.76; P for trend = .001). This association was only slightly attenuated after additional adjustment for intake of beta carotene, lutein/zeaxanthin, preformed vitamin A, and total vitamins C and E. The risk of breast cancer associated with alcohol intake was strongest among women with total folate intake of less than 300 microg/d (for alcohol intake > or =15 g/d vs <15 g/d, multivariate RR, 1.32; 95% CI, 1.15-1.50). For women who consumed at least 300 microg/d of total folate, the multivariate RR for intake of at least 15 g/d of alcohol vs less than 15 g/d was 1.05 (95% CI, 0.92-1.20). Current use of multivitamin supplements, the major source of folate, was associated with lower breast cancer risk among women who consumed at least 15 g/d of alcohol (for current users of supplements vs never users, RR, 0.74; 95% CI, 0.59-0.93).

CONCLUSIONS:

Our findings suggest that the excess risk of breast cancer associated with alcohol consumption may be reduced by adequate folate intake.

PMID:
10235158
[PubMed - indexed for MEDLINE]
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