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A randomized trial on folic acid supplementation and risk of recurrent colorectal adenoma
American Journal of Clinical Nutrition, 10/29/09

Wu K et al. – These results do not support an overall protective effect of folic acid supplementation on adenoma recurrence. Folic acid supplementation may be beneficial among those with lower folate concentrations at baseline.

• A double–blind, randomized trial among participants of 2 large prospective cohorts, the Health Professionals Follow–Up Study and the Nurses’ Health Study.
• Participants were randomly assigned to receive folic acid (1 mg/d) (n = 338) or placebo (n = 334) for 3–6.5 y.
• The primary endpoint was any new diagnosis of adenoma during the study period (May 1996–March 2004).
• Secondary outcomes were adenoma by site, stage, and number of recurrent adenomas. Associations were also examined by plasma folate concentrations at baseline.

• Incidence of at least one recurrent adenoma was not significantly associated with folic acid supplementation.
• Among participants with low plasma folate concentrations at baseline (<=7.5 ng/mL), those randomly assigned to receive folic acid experienced a significant decrease in adenoma recurrence, whereas for subjects with high folate concentrations at baseline (>7.5 ng/mL), supplemental folic acid had no significant effect.
• Contrary to findings from another clinical trial, there was no evidence for an increased risk of advanced or multiple adenomas.

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