Clinical Pathology and Laboratory Medicine 2024

The utility of laboratory measurement of folate in relation to the risk of cancer

Dr. Bremansu Osa-ANDREWS


(605) 651-3989

Faculty Department/Division
Clinical Pathology and Laboratory medicine

This project is primarily:

Research Project Description:
Following the FDA’s mandated folate-fortification of foods in the USA, the Choosing Wisely Campaign recommended that laboratories discontinue the measurement of blood folate levels. The Campaign instead suggested that clinicians should supplement folate in patients with suspected macrocytic anemia, without prior evaluation their folate status. However, the proposition to supplement folate without first testing may be challenged by recent reports associating high blood folate with the risk of certain cancers. In macrocytic anemia, the red blood cells are larger in size than normal with an MCV of >100 fL compared with normal and reduced size in normocytic and microcytic anemia respectively. Megaloblastic macrocytic anemia is caused by deficiency of either vitamin B12 or folate or both. Folate is required by cells for the synthesis of nucleic acids in cells and erythropoiesis. The physiological function of folate and vitamin B12 are connected in the sense that methyl folate is required for the activation of vitamin B12 to convert homocysteine to methionine, relieving the cardio-destructive effect of homocysteine. A recent retrospective study by our team underpinned the need to test for folate status in anemic patients. For proper patient care and patient safety, measurement of folate is a clinically useful test and this project among other things, seeks to provide evidence for this.

Research goals: This project will explore the utility of blood folate testing in the investigation of anemia, prevention of folate toxicity and vitamin B12 deficiency masking and the risks of cancers.

Student’s role: Students will be trained on how to retrieve patient results/data from the Electronic medical records (EPIC), filter and analyze the data. Students will also learn how to design, develop and write a manuscript including research articles. This is an exciting opportunity for students to engage in scholarly activity with the potential of publication.

The project does not currently have funding.

Relevant publication: Osa-Andrews B, Sanchez M, Hashim IA. The Continued Need for the Routine Assessment of Folate Status. Lab Med. 2023 Jul 5;54(4):424-428. doi: 10.1093/labmed/lmac148. PMID: 36637228.

Does this project have an international component or travel?