Association Between Dietary Folate and Prostate Cancer Aggressiveness Among African Americans and European Americans.

African American men with prostate cancer had a greater proportion of high aggressiveness diagnoses compared to European American men.

• 31.6% of AA subjects were diagnosed with high PCa aggressiveness compared to 21.7% of EA subjects
• This difference was statistically significant (p < 0.001)
• The study included 722 AA and 775 EA men with prostate cancer

Both African Americans and European Americans showed associations between decreased dietary folate equivalent (DFE) intake and higher prostate cancer aggressiveness after covariate adjustment.

• The association was observed across both racial groups after adjusting for covariates
• DFE was estimated using the National Cancer Institute Dietary History Questionnaire and detailed dietary supplement use questionnaire
• DFE encompasses total folate intake including both natural and synthetic sources

Among African Americans, the highest quartile of synthetic folate intake was associated with higher odds of high-aggressive prostate cancer compared to the lowest quartile.

• Adjusted OR = 1.39 for highest vs. lowest quartile of synthetic folate intake among AAs
• This association was not statistically significant (p = 0.27)
• Logistic regression was used to evaluate the association

Among European Americans, the highest quartile of synthetic folate intake was associated with lower odds of high-aggressive prostate cancer compared to the lowest quartile, in the opposite direction from African Americans.

• Adjusted OR = 0.62 for highest vs. lowest quartile of synthetic folate intake among EAs
• This association was not statistically significant (p = 0.14)
• The direction of the association was reversed compared to AAs (OR 1.39 vs. 0.62)

The association between folate intake and prostate cancer aggressiveness was evaluated as source-specific and modified by race.

• Interaction effects between folate intake levels and racial groups were tested to evaluate whether associations differed by race
• Three sources of folate were analyzed: dietary folate equivalent (DFE), synthetic folate, and natural folate
• The divergent findings by race and folate source highlight the need for population-informed nutritional guidance

The study population showed demographic and clinical differences between African American and European American prostate cancer patients.

• Univariable comparisons used t-test or Wilcoxon test for continuous variables and Chi-square test for categorical variables
• 722 AA and 775 EA men were included in the analysis
• Folate intake was estimated using both the NCI Dietary History Questionnaire and a detailed dietary supplement use questionnaire