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ABSTRACT: Background
Folates, including folic acid, may play a dual role in colorectal cancer development. Folate is suggested to be protective in early carcinogenesis but could accelerate growth of premalignant lesions or micrometastases. Whether circulating concentrations of folate and folic acid, measured around time of diagnosis, are associated with recurrence and survival in colorectal cancer patients is largely unknown.Methods
Circulating concentrations of folate, folic acid, and folate catabolites p-aminobenzoylglutamate and p-acetamidobenzoylglutamate were measured by liquid chromatography-tandem mass spectrometry at diagnosis in 2024 stage I-III colorectal cancer patients from European and US patient cohort studies. Multivariable-adjusted Cox proportional hazard models were used to assess associations between folate, folic acid, and folate catabolites concentrations with recurrence, overall survival, and disease-free survival.Results
No statistically significant associations were observed between folate, p-aminobenzoylglutamate, and p-acetamidobenzoylglutamate concentrations and recurrence, overall survival, and disease-free survival, with hazard ratios ranging from 0.92 to 1.16. The detection of folic acid in the circulation (yes or no) was not associated with any outcome. However, among patients with detectable folic acid concentrations (n = 296), a higher risk of recurrence was observed for each twofold increase in folic acid (hazard ratio = 1.31, 95% confidence interval = 1.02 to 1.58). No statistically significant associations were found between folic acid concentrations and overall and disease-free survival.Conclusions
Circulating folate and folate catabolite concentrations at colorectal cancer diagnosis were not associated with recurrence and survival. However, caution is warranted for high blood concentrations of folic acid because they may increase the risk of colorectal cancer recurrence.
SUBMITTER: Geijsen AJMR
PROVIDER: S-EPMC7583160 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Geijsen Anne J M R AJMR Ulvik Arve A Gigic Biljana B Kok Dieuwertje E DE van Duijnhoven Fränzel J B FJB Holowatyj Andreana N AN Brezina Stefanie S van Roekel Eline H EH Baierl Andreas A Bergmann Michael M MM Böhm Jürgen J Bours Martijn J L MJL Brenner Hermann H Breukink Stéphanie O SO Bronner Mary P MP Chang-Claude Jenny J de Wilt Johannes H W JHW Grady William M WM Grünberger Thomas T Gumpenberger Tanja T Herpel Esther E Hoffmeister Michael M Huang Lyen C LC Jedrzkiewicz Jolanta D JD Keulen Eric T P ETP Kiblawi Rama R Kölsch Torsten T Koole Janna L JL Kosma Katharina K Kouwenhoven Ewout A EA Kruyt Flip M FM Kvalheim Gry G Li Christopher I CI Lin Tengda T Ose Jennifer J Pickron T Bartley TB Scaife Courtney L CL Schirmacher Peter P Schneider Martin A MA Schrotz-King Petra P Singer Marie C MC Swanson Eric R ER van Duijvendijk Peter P van Halteren Henk K HK van Zutphen Moniek M Vickers Kathy K Vogelaar F Jeroen FJ Wesselink Evertine E Habermann Nina N Ulrich Alexis B AB Ueland Per M PM Weijenberg Matty P MP Gsur Andrea A Ulrich Cornelia M CM Kampman Ellen E
JNCI cancer spectrum 20200707 5
<h4>Background</h4>Folates, including folic acid, may play a dual role in colorectal cancer development. Folate is suggested to be protective in early carcinogenesis but could accelerate growth of premalignant lesions or micrometastases. Whether circulating concentrations of folate and folic acid, measured around time of diagnosis, are associated with recurrence and survival in colorectal cancer patients is largely unknown.<h4>Methods</h4>Circulating concentrations of folate, folic acid, and fol ...[more]