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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.

Methods

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.

Results

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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