Intended for healthcare professionals


Taking folate in pregnancy and risk of maternal breast cancer

BMJ 2005; 330 doi: (Published 10 March 2005) Cite this as: BMJ 2005;330:600

Authors and publishers must not disclaim ethical responsibility

  1. Gordon Stirrat, senior research fellow in ethics in medicine (g.m.stirrat{at}
  1. Centre for Ethics in Medicine, University of Bristol, Bristol BS2 8BH

EDITOR—On 10 December 2004 a banner headline on the front page of a popular tabloid newspaper read: “Cancer danger of folic acid” on the basis of a paper by Charles et al on taking folate in pregnancy and risk of maternal breast cancer.1 2 Although coverage in the broadsheets was more balanced, the overall message would inevitably cause concern to women taking folate to reduce the risk of fetal neural tube defect in a desired pregnancy.

Embedded Image


Despite the likelihood that the most likely explanation for the reported association is chance, as reported in the commentary to the paper,2 numerous susceptible women will probably not take folate, and some of these may conceive fetuses with neural tube defects. In addition, what company or government will take responsibility for fortification of wheat and corn flour with folate, now that this question has been raised?

The authors themselves point out that the numbers are small and the confidence intervals large. The risk was also associated with a much larger dose of folate than is routinely used to reduce the risk of neural tube defects.

Those who write such papers and those who publish them cannot disclaim ethical responsibility for how the data are interpreted and must consider more carefully their ethical responsibilities in such situations.


  • See Papers pp 571 and 574

  • Competing interests None declared.


  1. 1.
  2. 2.
View Abstract