ArticlePediatrics2012
Childhood cancer incidence trends in association with US folic acid fortification (1986-2008).
Article in Pediatrics, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Folate and global health umbrella review series, part 2: syntheses on cancers.Journal of global health · 2026Pooled it
- Prevention of congenital malformations and other adverse pregnancy outcomes with 4.0 mg of folic acid: community-based randomized clinical trial in Italy and the Netherlands.BMC pregnancy and childbirth · 2014Trial
- Causes of Childhood Cancer: A Review of Literature (2014-2021): Part 2-Pregnancy and Birth-Related Factors.Cancers · 2025Review
- Reduced murine double minute-2 methylation from peripheral blood mononuclear cells correlates with enhanced oxidative stress in hepatitis b virus-related hepatocellular carcinoma.Frontiers in microbiology · 2025Article
- Environmental risk factors of Wilms tumour: A systematic review and meta-analysis.EJC paediatric oncology · 2024Review
- Folic acid: friend or foe in cancer therapy.The Journal of international medical research · 2024Review
- Perinatal folate levels do not influence tumor latency or multiplicity in a model of NF1 associated plexiform-like neurofibromas.BMC research notes · 2023Article
- Maternal anemia and the risk of childhood cancer: A population-based cohort study in Taiwan.Pediatric blood & cancer · 2023Article
- Maternal anemia and childhood cancer: a population-based case-control study in Denmark.Cancer epidemiology · 2023Article
- The opportunities and challenges for nutritional intervention in childhood cancers.Frontiers in nutrition · 2023Review
- Folic Acid and the Prevention of Birth Defects: 30 Years of Opportunity and Controversies.Annual review of nutrition · 2022Review
- International patterns and trends of childhood and adolescent cancer, 1978-2012.Journal of the National Cancer Center · 2022Article
- Maternal folic acid and multivitamin supplementation: International clinical evidence with considerations for the prevention of folate-sensitive birth defects.Preventive medicine reports · 2021Review
- Incidence of childhood renal tumours: An international population-based study.International journal of cancer · 2020Article
- Acute leukemia in sickle cell disease patients in a tertiary health facility in Nigeria: a case series.African health sciences · 2020Article
- Fetal programming and Wilms tumor.Pediatric blood & cancer · 2019Article
- Folic acid, one-carbon metabolism & childhood cancer.The Indian journal of medical research · 2017Review
- Brain structure, working memory and response inhibition in childhood leukemia survivors.Brain and behavior · 2017Article
- Plasma Folate, Vitamin B12 and Homocysteine Levels in Children with Solid Tumors at Diagnosis; Results from a Pediatric Referral Centre.Indian journal of pediatrics · 2016Article
- Retrospective Assessment of Cost Savings From Prevention: Folic Acid Fortification and Spina Bifida in the U.S.American journal of preventive medicine · 2016Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveEpidemiologic evidence indicates that prenatal vitamin supplementation reduces risk for some childhood cancers; however, a systematic evaluation of population-based childhood cancer incidence trends after fortification of enriched grain products with folic acid in the United States in 1996-1998 has not been previously reported. Here we describe temporal trends in childhood cancer incidence in association with US folic acid fortification.
methodsUsing Surveillance, Epidemiology, and End Results program data (1986-2008), we calculated incidence rate ratios and 95% confidence intervals to compare pre- and postfortification cancer incidence rates in children aged 0 to 4 years. Incidence trends were also evaluated by using joinpoint and loess regression models.
resultsFrom 1986 through 2008, 8829 children aged 0 to 4 years were diagnosed with malignancies, including 3790 and 3299 in utero during the pre- and postfortification periods, respectively. Pre- and postfortification incidence rates were similar for all cancers combined and for most specific cancer types. Rates of Wilms tumor (WT), primitive neuroectodermal tumors (PNETs), and ependymomas were significantly lower postfortification. Joinpoint regression models detected increasing WT incidence from 1986 through 1997 followed by a sizable decline from 1997 through 2008, and increasing PNET incidence from 1986 through 1993 followed by a sharp decrease from 1993 through 2008. Loess curves indicated similar patterns.
conclusionsThese results provide support for a decrease in WT and possibly PNET incidence, but not other childhood cancers, after US folic acid fortification.
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