Folic acid and colorectal cancer risk update

The Agency’s Chief Executive, Tim Smith, has written to the Chief Medical Officer (CMO), Sir Liam Donaldson, with updated information on folic acid and cancer.

In December 2006, the Scientific Advisory Committee on Nutrition (SACN) published its report Folate and Disease Prevention in response to a request from the Department of Health and the FSA. In its report, SACN recommended mandatory fortification of flour in order to reduce the number of pregnancies affected by neural tube defects.

In June 2007, after considering this report and options for improving folate intake of women of child bearing age, the FSA Board recommended mandatory fortification of bread or flour with folic acid. The recommendation to Health Ministers was made with the condition that there are controls on voluntary fortification and clear guidance on the appropriate use of supplements containing folic acid.

In October 2007, the CMO of England, on behalf of UK CMOs, asked SACN to consider in further detail two studies on folic acid and colorectal cancer risk that had not been published at the time of the SACN report.

A working group, comprising members of SACN, the Committee on Carcinogenicity and an external cancer expert, considered these studies and the combined results of trials that had investigated the effect of B-vitamins (including folic acid) on cardiovascular disease, which also reported effects on cancer.

SACN has concluded that the new evidence does not provide a substantial basis to change its previous recommendation for the introduction of mandatory fortification with folic acid, with controls on voluntary fortification. However, SACN’s recommendation has been amended to clarify the advice on supplement use for particular population groups.

Since SACN’s advice regarding mandatory fortification has not changed significantly, the Agency’s advice of June 2007 remains unchanged. Now that the Agency has notified the CMO of SACN’s updated conclusion, the UK CMOs will advise Health Ministers.