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Folate intake and the risk of upper gastrointestinal cancers: A systematic review and meta‐analysis
Author(s) -
Tio Martin,
Andrici Juliana,
Cox Michael R,
Eslick Guy D
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12446
Subject(s) - medicine , odds ratio , meta analysis , esophageal cancer , gastroenterology , pancreatic cancer , confidence interval , cancer , publication bias , relative risk , risk factor , oncology
Background and Aim There is conflicting evidence on the association between folate intake and the risk of upper gastrointestinal tract cancers. In order to further elucidate this relationship, we performed a systematic review and quantitative meta‐analysis of folate intake and the risk of esophageal, gastric, and pancreatic cancer. Methods Four electronic databases ( M edline, P ub M ed, E mbase, and C urrent C ontents C onnect) were searched to J uly 26, 2013, with no language restrictions for observational studies that measured folate intake and the risk of esophageal cancer, gastric cancer, or pancreatic cancer. Pooled odds ratios and 95% confidence intervals were calculated using a random effects model. Results The meta‐analysis of dietary folate and esophageal cancer risk comprising of nine retrospective studies showed a decreased risk of esophageal cancer (odds ratio [ OR ] 0.59; 95% confidence interval [95% CI ] 0.51–0.69). The meta‐analysis of dietary folate and gastric cancer risk comprising of 16 studies showed no association ( OR 0.94; 95% CI 0.78–1.14). The meta‐analysis of dietary folate and pancreatic cancer risk comprising of eight studies showed a decreased risk of pancreatic cancer ( OR 0.66; 95% CI 0.49–0.89). Conclusion Dietary folate intake is associated with a decreased risk of esophageal and pancreatic cancer, but not gastric cancer. Interpretation of these relationships is complicated by significant heterogeneity between studies when pooled, and by small numbers of studies available to analyze when stratification is performed to reduce heterogeneity.