Doctors call on UK government to proceed with folic acid fortification of flour

December 13, 2007

A group of UK doctors have called on the UK government to proceed with folic acid fortification of flour to prevent neural tube defects in pregnancies, and not to be delayed by two papers which they say do not prove any connection between folic acid and colorectal cancer.

Dr Roger Bayston, Association for Spina Bifida and Hydrocephalus, Peterborough, UK, and colleagues discuss the delay, announced by the UK Food Standards Agency (FSA) on October 17, 2007, so that the Chief Medical Officer can consider "recent publications on the issue of folic acid and colorectal cancer."

The doctors say that the two likely papers to be considered are by Cole and colleagues and Mason and colleagues; in the former, they say no link between colorectal carcinoma and folic acid supplementation is proven. And in the latter, the authors of that paper suggest that there is a temporal association between folic acid supplementation and the increase in colorectal cancer in the USA and Canada since 1996. But the doctors say: "Mandatory folic acid fortification was in place by Jan 1, 1998, in the USA and about a year later in Canada. The rise in colorectal cancer incidence therefore started before the introduction of fortification on any large scale and so could not have been caused by fortification."

They conclude: "The FSA and the Chief Medical Officer can be confident in recommending that the UK government introduce the mandatory fortification of flour, which could prevent about 400 pregnancies affected by neural tube defects each year, reducing both the number of terminations of pregnancy and of children born with these defects."
The paper associated with this release is at


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