Folic acid supplementation in prevention of colorectal adenoma recurrence: a meta-analysis

Abstract

Objective To evaluate the role of folic acid supplementation in prevention of colorectal adenoma recurrence. Methods Weconducted computer search of the Cochrane Central Register of Clinical Trails,Pubmed,Embase,CBMdisc and CNKI. Hand search of relevant journals and conference proceedings was also conducted. Based on the predefined inclusion and exclusion criteria,randomized controlled trials( RCT) about folic acid in treatment of patients after adenoma resection were included in the present study. After evaluating the quality of studies,meta-analyses were performed by RevMan 5. 0. 24 software for the pooled recurrence risks of colorectal adenoma and progressive colorectal adenoma. Results A total of 6 RCT studies,including 2,002 patients,were enrolled in this study. The results of meta-analysis showed that the recurrence risks of colorectal adenomas were not significantly different between folic acid supplementation and placebo groups [RR =0. 97,95% CI( 0. 79,1. 19) ,P = 0. 76]; but there were significant differences in the risks of progressive adenomas between the two groups[RR = 1. 33,95% CI ( 1. 01,1. 74) ,P = 0. 04]; and this effect of folic acid supplementation appeared when 1 mg/d folic acid supplementation was applied for ≥3 years [RR = 1. 49,95% CI( 1. 07,2. 09) ,P = 0. 02]. Conclusion Folic acid supplementation fails to reduce the risk of colorectal adenoma recurrence,and it might increase the recurrence risk of advanced adenoma.