TABLE 2.
Hazard ratios (HRs) for pancreatic cancer according to quartiles of baseline folate intakes for men (n = 51,988) and women (n = 57,187) who participated in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (1998–2006)
| Quartiles |
Multivitamin use |
|||||||
| 1 | 2 | 3 | 4 | P for trend | Continuous HR | No | Yes | |
| Women | ||||||||
| Natural folate (μg/d)1 | ≤125.6 | 125.7–151.1 | 151.2–183.2 | ≥183.3 | ||||
| No. of cases | 26 | 25 | 25 | 28 | ||||
| HR (95% CI)2 | 1 | 0.69 (0.38, 1.25) | 0.87 (0.50, 1.51) | 0.93 (0.54, 1.60) | 0.95 | |||
| HR (95% CI)3 | 1 | 0.62 (0.33, 1.16) | 0.81 (0.45, 1.47) | 0.72 (0.39, 1.35) | 0.51 | 0.69 (0.40, 1.20) | ||
| Fortified folic acid (μg/d)4 | ≤ 48.3 | 48.4–65.6 | 65.7–90.0 | ≥90.1 | ||||
| No. of cases | 31 | 22 | 23 | 28 | ||||
| HR (95% CI)2 | 1 | 0.70 (0.40, 1.23) | 0.69 (0.39, 1.21) | 0.83 (0.49, 1.40) | 0.63 | |||
| HR (95% CI)3 | 1 | 0.63 (0.35, 1.14) | 0.69 (0.39, 1.23) | 0.72 (0.41, 1.26) | 0.39 | 0.72 (0.42, 1.21) | ||
| Food folate (μg/d)5 | ≤179.1 | 179.2–213.1 | 213.2–253.2 | ≥253.3 | ||||
| No. of cases | 27 | 18 | 38 | 21 | ||||
| HR (95% CI)2 | 1 | 0.66 (0.35, 1.23) | 1.34 (0.80, 2.26) | 0.72 (0.39, 1.31) | 0.63 | |||
| HR (95% CI)3 | 1 | 0.58 (0.30, 1.12) | 1.06 (0.60, 1.88) | 0.47 (0.23, 0.94) | 0.09 | 0.56 (0.31, 1.00) | ||
| Supplemental folic acid (μg/d)6 | 0 | <400 | ≥400 | |||||
| No. of cases | 37 | 12 | 55 | |||||
| HR (95% CI)2 | 1 | 0.75 (0.39, 1.46) | 0.92 (0.60, 1.43) | 0.81 | ||||
| HR (95% CI)3 | 1 | 0.80 (0.41, 1.56) | 0.87 (0.55, 1.36) | 0.58 | ||||
| Total folate (μg/d)7 | ≤238.9 | 239.0–399.0 | 399.1–534.2 | ≥534.3 | ||||
| No. of cases | 29 | 30 | 24 | 21 | ||||
| HR (95% CI)2 | 1 | 1.12 (0.66, 1.91) | 0.79 (0.44, 1.41) | 0.69 (0.38, 1.25) | 0.12 | |||
| HR (95% CI)3 | 1 | 1.01 (0.58, 1.76) | 0.75 (0.41, 1.36) | 0.56 (0.30, 1.06) | 0.04 | 0.65 (0.37, 1.14) | ||
| Multivitamin use | ||||||||
| No. of cases | 82 | 22 | ||||||
| HR (95% CI)2 | 1 | 0.81 (0.49, 1.32) | ||||||
| HR (95% CI)3 | 1 | 0.82 (0.49, 1.36) | ||||||
| Men | ||||||||
| Natural folate (μg/d)1 | ≤109.7 | 109.8–131.1 | 131.2–157.6 | ≥157.7 | ||||
| No. of cases | 37 | 35 | 48 | 42 | ||||
| HR (95% CI)2 | 1 | 0.79 (0.49, 1.27) | 1.06 (0.68, 1.65) | 0.89 (0.56, 1.41) | 0.89 | |||
| HR (95% CI)3 | 1 | 0.83 (0.51, 1.38) | 1.11 (0.69, 1.78) | 0.91 (0.55, 1.53) | 0.92 | 1.25 (0.79, 1.96) | ||
| Fortified folic acid (μg/d)4 | ≤47.4 | 47.5–66.8 | 66.9–94.5 | ≥94.6 | ||||
| No. of cases | 38 | 48 | 25 | 51 | ||||
| HR (95% CI)2 | 1 | 1.26 (0.81, 1.95) | 0.66 (0.39, 1.10) | 1.04 (0.67, 1.63) | 0.70 | |||
| HR (95% CI)3 | 1 | 1.31 (0.84, 2.04) | 0.65 (0.38, 1.10) | 1.06 (0.66, 1.70) | 0.73 | 0.96 (0.65, 1.41) | ||
| Food folate (μg/d)5 | ≤ 158.0 | 158.1–190.0 | 190.1–229.5 | ≥ 229.6 | ||||
| No. of cases | 34 | 46 | 27 | 55 | ||||
| HR (95% CI)2 | 1 | 1.17 (0.73, 1.85) | 0.69 (0.41, 1.16) | 1.16 (0.73, 1.84) | 0.74 | |||
| HR (95% CI)3 | 1 | 1.21 (0.75, 1.96) | 0.71 (0.41, 1.24) | 1.20 (0.70, 2.04) | 0.67 | 1.27 (0.81, 2.00) | ||
| Supplemental folic acid (μg/d)6 | 0 | <400 | ≥400 | |||||
| No. of cases | 67 | 25 | 70 | |||||
| HR (95% CI)2 | 1 | 1.25 (0.78, 2.01) | 1.07 (0.76, 1.52) | 0.73 | ||||
| HR (95% CI)3 | 1 | 1.33 (0.82, 2.17) | 1.15 (0.81, 1.64) | 0.45 | ||||
| Total folate (μg/d)7 | ≤186.9 | 187.0–280.6 | 280.7–413.5 | ≥413.6 | ||||
| No. of cases | 43 | 31 | 38 | 50 | ||||
| HR (95% CI)2 | 1 | 0.65 (0.40, 1.05) | 0.85 (0.54, 1.34) | 0.89 (0.57, 1.39) | 0.87 | |||
| HR (95% CI)3 | 1 | 0.70 (0.43, 1.16) | 0.91 (0.57, 1.47) | 0.95 (0.59, 1.54) | 0.65 | 1.26 (0.78, 2.02) | ||
| Multivitamin use | ||||||||
| No. of cases | 130 | 32 | ||||||
| HR (95% CI)2 | 1 | 0.95 (0.63, 1.43) | ||||||
| HR (95% CI)3 | 1 | 0.94 (0.62, 1.42) | ||||||
| Sexes combined8 | ||||||||
| Natural folate (μg/d)1 | ||||||||
| HR (95% CI)3 | 1 | 0.68 (0.27, 1.08) | 0.96 (0.58, 1.34) | 0.81 (0.41, 1.21) | 0.94 (0.58, 1.30) | |||
| Fortified folic acid (μg/d)4 | ||||||||
| HR (95% CI)3 | 1 | 0.90 (0.52, 1.27) | 0.61 (0.37, 0.84) | 0.87 (0.50, 1.24) | 0.82 (0.49, 1.15) | |||
| Food folate (μg/d)5 | ||||||||
| HR (95% CI)3 | 1 | 0.83 (0.43, 1.24) | 0.90 (0.51, 1.30) | 0.73 (0.29, 1.17) | 0.86 (0.48, 1.23) | |||
| Supplemental folic acid (μg/d)6 | 0 | <400 | ≥400 | |||||
| HR (95% CI)3 | 1 | 1.02 (0.61, 1.44) | 1.00 (0.71, 1.29) | |||||
| Total folate (μg/d)7 | ||||||||
| HR (95% CI)3 | 1 | 0.84 (0.47, 1.22) | 0.81 (0.43, 1.20) | 0.69 (0.28, 1.09) | 0.90 (0.53, 1.27) | |||
| Multivitamin use | ||||||||
| HR (95% CI)3 | 1 | 0.86 (0.53, 1.19) | ||||||
Polyglutamates found naturally in food.
Cox proportional hazards regression with the use of a univariate model. Adjusted for total energy and should be considered as adjusted for age because age is the time metric.
Cox proportional hazards regression with the use of a multivariable model. Adjusted for total energy, smoking, self-reported diabetes, BMI, and saturated fat intake with age as the time metric.
Folic acid from fortified grain.
Natural folate and fortified folic acid combined.
Folic acid from vitamin supplements.
Food folate and supplemental folic acid combined.
Multivariable analysis of men and women combined used sex-specific cutoffs for folate intakes.