Pediatric cancer rates after universal folic acid flour fortification in ontario

Sandy G. Grupp, Mark L. Greenberg, Joel G. Ray, Usoa Busto, Krista L. Lanctôt, Irena Nulman, Gideon Koren

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)60-65
Number of pages6
JournalJournal of Clinical Pharmacology
Volume51
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

Keywords

  • Clinical pharmacology
  • clinical trials
  • geriatrics
  • pharmacokinetics and drug metabolism
  • pharmacology

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