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A Case-Control Study of Serum Folate Levels and Invasive Cervical Cancer¹

Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20892 [N. P., L. A. B.]; Microbiological Associates, Inc., Rockville, Maryland 20850 [V. A. L.]; Centers for Disease Control, Atlanta, Georgia 30333 [W. C. R.]; Gorgas Memorial Laboratory, Panama City, Republic of Panama [M. M. B.]; Unidad Nacional de Cancerologia, Caja Costarricense de Seguro Social, San Jose, Costa Rica [R. H.]; Hospital de Oncologia Nacional, Instituto Mexicano de Seguridad Social, Mexico City, Mexico [F. T.]; Instituto Oncologico Nacional, Panama, Republic Panama [R. C. d. B.]; and Division de Epidemiologia, Instituto Nacional de Cancerologia, Bogota, Columbia [E. G.]

Although small intervention trials have suggested that folate supplementation reduces cervical dysplasia, the association of blood folate concentrations with invasive cervical cancer risk has not been investigated in well-controlled epidemiological studies. A study was conducted with newly diagnosed Stage I and II invasive cervical cancer cases and controls in 4 Latin American countries. Ninety-five% of subjects donated blood samples, resulting in 330 case and 565 control serum samples analyzed for folate concentrations by radioassay. Cases did not differ significantly from controls in mean levels of folate (5.00 and 4.90 ng/ml, respectively). No associations were observed between quartiles of serum folate and risk of cervical cancer after adjustment for other risk factors, and no interactions with established risk factors were observed. Folate levels were also unrelated to risk among women who might have compromised folate status because of recent or extended oral contraceptive usage or multiple pregnancies. Further, mean levels of folate were similar by stage of disease, arguing against an effect of disease progression on serum values. These results do not support a role for serum folate in the etiology of invasive cervical cancer.

¹ Supported in part by Contract N01-CP-41026 and Grant R01-CA-42042 from the National Cancer Institute, NIH, and by a grant from the National Cancer Institute of Canada.

² To whom requests for reprints should be addressed, at Environmental Epidemiology Branch, National Cancer Institute, Executive Plaza North, Room 443, Bethesda, MD 20892.

Received 4/29/91. Accepted 7/ 9/91.

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