Intake of folate and related nutrients in relation to risk of epithelial ovarian cancer

Assessments of the relation between folate intake and ovarian cancer risk have been limited and inconsistent. Therefore, the authors prospectively examined the association of dietary and supplemental intakes of folate, methionine, and vitamin B-6 with ovarian cancer risk among 80,254 Nurses' Health Study participants. Beginning in 1976, women completed biennial questionnaires assessing ovarian cancer risk factors; starting in 1980, food frequency questionnaires were administered every 2-4 years. During 22 years of follow-up (1980-2002), the authors confirmed 481 incident epithelial ovarian cancers. There were no associations between total folate (top quintile vs. bottom: relative risk (RR) = 1.21, 95% confidence interval (Cl): 0.92,1.60), methionine (RR = 1.00, 95% Cl: 0.76, 1.33), dietary vitamin B-6 (RR = 1.09, 95% Cl: 0.81, 1.47), or total vitamin B-6 (RR = 1.13, 95% Cl: 0.85, 1.51) intake and ovarian cancer risk. Higher dietary folate was associated with a modestly decreased risk after exclusion of cases diagnosed during the 4 follow-up years after dietary assessment (RR = 0.66, 95% Cl: 0.43, 1.03) and for the serous subtype (RR = 0.51, 95% Cl: 0.31, 0.84). Results did not vary by alcohol intake, multivitamin use, menopausal status, or oral contraceptive use. There was little evidence that folate, methionine, and vitamin B6 are important in ovarian cancer risk, although dietary folate was inversely associated with risk in some analyses.