Pediatric Cancer Rates After Universal Folic Acid Flour Fortification In Ontario

Following the introduction of mandatory Canadian folic acid flour fortification in mid‐1997, the incidence of selected childhood cancers that declined in Ontario prior to and subsequent to this public policy initiative was examined. A population‐based cohort study of all incident cases of childhood...

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Bibliographic Details
Published in:Journal of clinical pharmacology 2011-01, Vol.51 (1), p.60-65
Main Authors: Grupp, Sandy G., Greenberg, Mark L., Ray, Joel G., Busto, Usoa, Lanctôt, Krista L., Nulman, Irena, Koren, Gideon
Format: Article
Language:English
Subjects:
Cancer
Child
Child, Preschool
Clinical pharmacology
clinical trials
Cohort Studies
Confidence intervals
Folic Acid - administration & dosage
Folic Acid - pharmacology
Food, Fortified
geriatrics
Health risk assessment
Humans
Infant
Kidney Neoplasms - epidemiology
Kidney Neoplasms - genetics
Kidney Neoplasms - prevention & control
Neoplasms - epidemiology
Neoplasms - pathology
Neoplasms - prevention & control
Ontario - epidemiology
Pediatrics
pharmacokinetics and drug metabolism
pharmacology
Registries
Retrospective Studies
Wilms Tumor - epidemiology
Wilms Tumor - prevention & control
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Summary:Following the introduction of mandatory Canadian folic acid flour fortification in mid‐1997, the incidence of selected childhood cancers that declined in Ontario prior to and subsequent to this public policy initiative was examined. A population‐based cohort study of all incident cases of childhood malignancy in Ontario between the years 1985 and 2006 was conducted. Participants were identified from a database provided by the Pediatric Oncology Group of Ontario and included children 0 to 4 years of age and 5 to 9 years of age who were diagnosed with cancer. Among children aged 0 to 4 years, the incidence rate of Wilms' tumor declined from 1.94 to 1.43 per 100 000 (incidence rate ratio 0.74, 95% confidence interval, 0.57–0.95). No significant change was seen in the prefortification vs postfortification time periods for acute lymphoblastic leukemia, brain cancers, or embryonal cancers among the 0‐ to 4‐year or 5‐ to 9‐year age groups. There was an approximately 30% reduction in risk of Wilms' tumor following introduction of the initiative. This corroborates a recent case‐control study from Germany. These data may also provide some reassurance that universal flour fortification does not heighten the risk of pediatric cancer.
ISSN:0091-2700
1552-4604
DOI:10.1177/0091270010365553