Dietary folate intake and pancreatic cancer risk: Results from the European prospective investigation into cancer and nutrition

Jin Young Park, H Bas Bueno-de-Mesquita, Pietro Ferrari, Elisabete Weiderpass, Jordi de Batlle, Anne Tjønneland, Cecilie Kyro, Vinciane Rebours, Marie-Christine Boutron-Ruault, Francesca Romana Mancini, Verena Katzke, Tilman Kühn, Heiner Boeing, Antonia Trichopoulou, Carlo La Vecchia, Maria Kritikou, Giovanna Masala, Valeria Pala, Rosario Tumino, Salvatore PanicoPetra H Peeters, Guri Skeie, Susana Merino, Eric J Duell, Miguel Rodríguez-Barranco, Miren Dorronsoro, Maria-Dolores Chirlaque, Eva Ardanaz, Björn Gylling, Jörn Schneede, Ulrika Ericson, Hanna Sternby, Kay-Tee Khaw, Kathryn E Bradbury, Inge Huybrechts, Dagfinn Aune, Paolo Vineis, Nadia Slimani

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Pancreatic cancer (PC) has an exceptionally low survival rate and primary prevention strategies are limited. Folate plays an important role in one-carbon metabolism and has been associated with the risk of several cancers, but not consistently with PC risk. We aimed to investigate the association between dietary folate intake and PC risk, using the standardised folate database across 10 European countries. A total of 477,206 participants were followed up for 11 years, during which 865 incident primary PC cases were recorded. Folate intake was energy-adjusted using the residual method. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. In multivariable analyses stratified by age, sex, study centre and adjusted for energy intake, smoking status, BMI, educational level, diabetes status, supplement use and dietary fibre intake, we found no significant association between folate intake and PC risk: the HR of PC risk for those in the highest quartile of folate intake (≥353 μg/day) compared to the lowest (<241 μg/day) was 0.81 (95% CI: 0.51, 1.31; ptrend = 0.38). In current smokers, a positive trend was observed in PC risk across folate quartiles [HR = 4.42 (95% CI: 1.05, 18.62) for ≥353 μg/day vs. <241 μg/day, ptrend = 0.01]. Nonetheless, there was no significant interaction between smoking and dietary folate intake (pinteraction = 0.99). We found no association between dietary folate intake and PC risk in this large European study.

Original languageEnglish
Pages (from-to)1511-1521
Number of pages11
JournalInternational Journal of Cancer
Issue number7
Early online date04 Sept 2018
Publication statusPublished - 01 Apr 2019

Bibliographical note

© 2018 UICC.


  • Adult
  • Europe/epidemiology
  • Female
  • Folic Acid/administration & dosage
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status
  • Pancreatic Neoplasms/epidemiology
  • Proportional Hazards Models
  • Prospective Studies
  • Self Report
  • Smoking/adverse effects


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