Abstract
Previous epidemiologic research suggests a protective role of one-carbon nutrients in carcinogenesis. Folate, however, may play a dual role in neoplasms development: protect early in carcinogenesis and promote carcinogenesis at a later stage. We prospectively examined associations between intake of total folate, methionine, riboflavin, vitamin B6, and risk of lymphoid and myeloid neoplasms (including subtypes) and investigated whether alcohol modified the effects of folate. The Netherlands Cohort Study consists of 120,852 individuals who completed a baseline questionnaire in 1986, including a 150-item food-frequency questionnaire. After 17.3 years of follow-up, 1,280 cases of lymphoid and 222 cases of myeloid neoplasms were available for analysis. Intakes of folate, methionine, and riboflavin were not associated with lymphoid or myeloid neoplasms. For vitamin B6, a statistically significantly increased myeloid neoplasms risk was observed (highest vs. lowest quintile: HR = 1.87; 95% confidence intervals, 1.08-3.25). When analyzing by lymphoid and myeloid neoplasms subtypes, no clear associations were observed for most subtypes, with just a few increased risks for some subtypes and nutrients. Some risks became nonsignificant after excluding early cases. No interaction between alcohol and folate was observed. We observed a few significant positive associations; however, some of these would be expected to arise due to chance alone. Furthermore, some risks became nonsignificant after excluding early cases. Therefore, we conclude that there is no association between one-carbon nutrient intake and risk of lymphoid and myeloid neoplasms. This study contributes substantially to the limited and inconclusive evidence on the association with one-carbon nutrients.
Highlights
Hematologic malignancies are a heterogeneous group of neoplasms that originate from lymphoid and myeloid cells
We investigated the relations between dietary one-carbon nutrients [i.e., total folate, poly- and monoglutamates, riboflavin, vitamin B6, and methionine] and risk of lymphoid and myeloid neoplasms, including the most common subtypes, in a large prospective cohort study of men and women in the Netherlands
The analysis was performed for lymphoid (n 1⁄4 1,280) and myeloid neoplasms (n 1⁄4 222) overall and for specific subtypes with a sufficient number of incident cases (n 70, as used in a previous analysis within the Netherlands Cohort Study (NLCS); ref. 38; Table 1)
Summary
Hematologic malignancies are a heterogeneous group of neoplasms that originate from lymphoid and myeloid cells. They account for 7.4% of cancers in males and 6.4% in females worldwide [1]. Risk factors for myeloid neoplasms include age, gender, genetic abnormalities, family history, and exposures to radiation and benzene [3]. Stratification for subtypes of lymphoid and myeloid neoplasms in previous studies suggested etiologic heterogeneity [4, 5] and, further research is warranted in which these subtypes with sufficient numbers can be examined. We prospectively examined associations between intake of total folate, methionine, riboflavin, vitamin B6, and risk of lymphoid and myeloid neoplasms (including subtypes) and investigated whether alcohol modified the effects of folate
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