Epidemiology

Lower neuroblastoma rates linked to folate fortification

Last Updated: 2003-10-02 9:45:26 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Since Canada began fortifying its flour with folate in 1997, neuroblastoma rates have dropped considerably, new research suggests.

Maternal folic acid intake has been tied to a decreased risk of several childhood cancers, but its relationship to the risk of neuroblastoma was not known.

Dr. Gideon Koren, from The Hospital for Sick Children in Toronto, and colleagues used data from an Ontario cancer registry to determine the rates of neuroblastoma, acute lymphoblastic leukemia (ALL), and hepatoblastoma before and after folate food fortification occurred.

The researchers' findings are reported in Clinical Pharmacology and Therapeutics for September.

Prior to fortification, 1.57 cases of neuroblastoma were seen for every 10,000 births, the authors note. After fortification, the incidence fell significantly to 0.62 cases per 10,000 births (p < 0.0001). Moreover, a significant difference remained even after accounting for age and disease stage at diagnosis.

In contrast, ALL and hepatoblastoma rates did not change after folate fortification, the researchers point out.

"Although the incidence of neuroblastoma may have declined in association with folic acid fortification, longer follow-up data would better confirm these findings," the authors state.

"It also remains to be determined whether folic acid is efficacious as an additional agent in the management of existing neuroblastoma or for prevention of disease relapse in successfully treated patients," they conclude.

Clin Pharmacol Ther 2003;74:288-294.