Oral folic acid supplementation for cervical dysplasia: A clinical intervention trial

Objective: We attempted to evaluate the effect of oral folic acid supplementation on the course of cervical dysplasia. Study Design: A total of 235 subjects with grade 1 or 2 cervical intraepithelial neoplasia were randomly assigned to receive either 10 mg of folic acid or a placebo daily for 6 months. Clinical status, human papillomavirus type 16 infection, and blood folate levels were monitored at 2-month intervals. Outcome data were subjected to χ2 analysis. Results: The prevalence of human papillomavirus type 16 infection initially was 16% among subjects in the upper fertile of red blood cell folate versus 37% in the lower fertile (trend p = 0.035). After 6 months no significant differences were observed between supplemented and unsupplemented subjects regarding dysplasia status, biopsy results, or prevalence of human papillomavirus type 16 infection. Conclusion: Folate deficiency may be involved as a cocarcinogen during the initiation of cervical dysplasia, but folic acid supplements do not alter the course of established disease.