Folic acid deficiency and cervical dysplasia
1993
Butterworth, C.E. Jr
Cervical dysplasia is generally regarded as the earliest detectable stage of cervical cancer. It is readily curable, but early detection and treatment place a heavy burden on the health care delivery system; primary prevention would be a desirable alternative. The probable causative agent, human papilloma virus, can be found in some normal biopsies as well as in dysplastic tissue, suggesting differences in viral gene expression. In a recent case-control study of women with the human papilloma virus, the risk of dysplasia was fivefold greater among women in the lower two tertiles of red blood cell folate content than in the highest. Folate deficiency may facilitate incorporation of human papilloma virus genomes into host chromosomes at a folate-sensitive fragile site. Oral folate supplements do not alter the course of established disease. However, evidence suggests that a significant reduction in early cervical cancer could be achieved in up to two-thirds of high-risk populations through improved nutritional intake of folate before exposure to an oncogenic strain of papilloma virus.
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