What is known?
Mandatory fortification of bread flour with folic acid has helped to reduce the incidence of neural tube defects in several countries. Reports from some countries using population-level data have suggested that mandatory folic acid food fortification programs have increased the incidence of colorectal cancer. Mandatory folic acid fortification of bread flour was introduced in Australia in 2009.
What is new?
Age-standardised colorectal cancer incidence have generally decreased since 1999, with these decreases being by about 0·4% per year between 1999 to 2010 and by 2·2% per year between 2010 and 2016.
What does this mean?
Definitive evidence requires more complex study designs such as large-scale cohort studies or randomised controlled trials. However, these population-level results using cancer registry data support the hypothesis that the introduction of mandatory folic acid fortification of bread flour has not influenced colorectal cancer incidence in Australia.
Contact: Peter Baade
Reference: van der Pols J, Baade P, Spencer L. Colorectal cancer incidence in Australia before and after mandatory fortification of bread flour with folic acid. Public Health Nutrition. 2021. doi: 10.1017/S1368980021000562:1-4