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Dietary factors of one-carbon metabolism and prostate cancer risk^1,2,3

¹ From the Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD (SJW, RS-S, PRT, and DA), and the Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland (PP and JV)

Background: Folate is hypothesized to be inversely associated with the risk of several cancers, but such a potential association has not been well studied for prostate cancer. Vitamin B-6, vitamin B-12, methionine, and alcohol can influence folate-related metabolism.

Objective: The objective was to investigate the associations between dietary factors of one-carbon metabolism and prostate cancer risk within the -Tocopherol, ß-Carotene Cancer Prevention Study.

Design: Of the cohort's 27 111 Finnish male smokers aged 50–69 y who had complete dietary data, 1270 had a diagnosis of incident prostate cancer between 1985 and 2002. Folate, vitamin B-6, vitamin B-12, methionine, and alcohol intakes were estimated from a 276-item modified dietary history questionnaire. Cox proportional hazard models, adjusted for age and vitamin supplement use, estimated relative risks (RR) and 95% CIs.

Results: Vitamin B-6 intake was inversely associated with prostate cancer risk (RR for highest versus lowest quintile: 0.88; 95% CI: 0.72, 1.07; P for trend = 0.045), whereas vitamin B-12 intake was associated with significantly increased risk (RR = 1.36; 95% CI: 1.14, 1.96; P for trend = 0.01). No association between folate or alcohol intake and prostate cancer risk was observed. No differences were found in the above associations according to stage of disease or subgroups of several potential effect modifiers.

Conclusions: We found no convincing evidence for a protective role of one-carbon metabolism against prostate cancer, although these observations can be generalized only to smokers. The possible modest protective association with vitamin B-6 and the significantly elevated risk with vitamin B-12 intake warrant further investigation.

Key Words: Prostatic neoplasms • folic acid • vitamin B-6 • vitamin B-12 • methionine • alcohol

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