Folic Acid Enrichment May Reduce Specific Pediatric Cancers

Postfortification of grains, decrease seen in Wilms tumor, primitive neuroectodermal tumor incidence

MONDAY, May 21 (HealthDay News) -- Following mandatory folic acid fortification of enriched grain products in the United States in 1996 to 1998, there has been a decrease in the incidence of some childhood cancers, including Wilms tumor (WT) and primitive neuroectodermal tumors (PNETs), according to a study published online May 21 in Pediatrics.

Amy M. Linabery, Ph.D., from the University of Minnesota in Minneapolis, and colleagues analyzed Surveillance, Epidemiology, and End Results program data (1986 to 2008) to compare the cancer incidence rates in children (aged 0 to 4 years) before and after folate fortification. Joinpoint and loess regression models were used to assess incidence trends.

The researchers found that, over the study period, 8,829 children were diagnosed with malignancies, including 3,790 in utero during the prefortification period and 3,299 in utero during the postfortification period. For all cancers combined, and for most cancer types, the pre- and postfortification incidence rates were similar. Postfortification incidence rates of WT, PNETs, and ependymomas were significantly lower. Rates of WT incidence increased from 1986 through 1997 and declined substantially from 1997 through 2008. Incidence of PNET increased from 1986 through 1993 but decreased sharply from 1993 through 2008.

"Declines in WT and PNET incidence were detected by multiple analytic strategies," the authors write. "Alternative study designs, such as prenatal feeding experiments in animal models, are required to rule out other explanations, confirm causal relationships, and elucidate mechanisms."

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