Folate intake, serum folate levels and esophageal cancer risk: an overall and dose-response meta-analysis
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Yan Zhao1, Chenyang Guo1, Hongtao Hu1, Lin Zheng1, Junli Ma1, Li Jiang1, Erjiang Zhao2, Hailiang Li1
1Department of Radiology Intervention, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan, China
2Department of Epidemiology and Biostatistics, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan, China
Hailiang Li, email: [email protected]
Keywords: folate, esophageal cancer, dose-response, meta-analysis
Received: August 17, 2016 Accepted: December 12, 2016 Published: January 02, 2017
Previously reported findings on the association between folate intake or serum folate levels and esophageal cancer risk have been inconsistent. This study aims to summarize the evidence regarding these relationships using a dose-response meta-analysis approach. We performed electronic searches of the Pubmed, Medline and Cochrane Library electronic databases to identify studies examining the effect of folate on the risk of esophageal cancer. Ultimately, 19 studies were included in the meta-analysis. Summary odds ratios (ORs) were estimated using a random effects model. A linear regression analysis of the natural logarithm of the OR was carried out to assess the possible dose-response relationship between folate intake and esophageal cancer risk. The pooled ORs for esophageal cancer in the highest vs. lowest levels of dietary folate intake and serum folate were 0.63 (95% CI: 0.56-0.71) and 0.71 (95% CI: 0.55-0.92), respectively. The dose-response meta-analysis indicated that a 100 μg/day increment in dietary folate intake reduced the estimate risk of esophageal cancer by 12%. These findings suggest that dietary and serum folate exert a protective effect against esophageal carcinogenesis.
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