Folate Intake and Risk of Pancreatic Cancer: Pooled Analysis of Prospective Cohort Studies

Ying Bao, Dominique S. Michaud, Donna Spiegelman, Demetrius Albanes, Kristin E. Anderson, Leslie Bernstein, Piet A. van den Brandt, Dallas R. English, Jo L. Freudenheim, Charles S. Fuchs, Graham G. Giles, Edward Giovannucci, R. Alexandra (Sandra) Goldbohm, Niclas Hakansson, Pamela L. Horn-Ross, Eric J. Jacobs, Cari M. Kitahara, James R. Marshall, Anthony B. Miller, Kim RobienThomas E. Rohan, Arthur Schatzkin, Victoria L Stevens, Rachael Z. Stolzenberg-Solomon, Jarmo Virtamo, Alicja Wolk, Regina G. Ziegler, Stephanie A. Smith-Warner*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

27 Citations (Web of Science)


Background Epidemiological studies evaluating the association between folate intake and risk of pancreatic cancer have produced inconsistent results. The statistical power to examine this association has been limited in previous studies partly because of small sample size and limited range of folate intake in some studies. Methods We analyzed primary data from 14 prospective cohort studies that included 319 716 men and 542 948 women to assess the association between folate intake and risk of pancreatic cancer. Folate intake was assessed through a validated food-frequency questionnaire at baseline in each study. Study-specific relative risks (RRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models and then pooled using a random effects model. All statistical tests were two-sided. Results During 7-20 years of follow-up across studies, 2195 pancreatic cancers were identified. No association was observed between folate intake and risk of pancreatic cancer in men and women (highest vs lowest quintile: dietary folate intake, pooled multivariable RR = 1.06, 95% CI = 0.90 to 1.25, P-trend = .47; total folate intake [dietary folate and supplemental folic acid], pooled multivariable RR = 0.96, 95% CI = 0.80 to 1.16, P-trend = .90). No between-study heterogeneity was observed (for dietary folate, P-heterogeneity = .15; for total folate, P-heterogeneity = .22). Conclusion Folate intake was not associated with overall risk of pancreatic cancer in this large pooled analysis.
Original languageEnglish
Pages (from-to)1840-1850
JournalJournal of the National Cancer Institute
Issue number24
Publication statusPublished - Dec 2011

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