{"id":"5b096da7-9d8e-5a66-add0-f4604c35ece2","stable_key":"ec174d5a-4903-5745-8646-df0e9d4265e8:fol-advanced-lesion-later-signal","predicate":"associated_with_later_advanced_lesion_signal","statement":"Among 607 participants with a second follow-up, advanced lesions occurred in 11.6% versus 6.9% (RR 1.67; 95% CI 1.00–2.80; P=0.05).","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"positive","is_public":true,"mechanism_event_id":"2cd84b4c-ce49-5df9-b241-0df0fd5afc8b","mechanism_event_label":"The later follow-up raised a possible adverse signal that must remain visible.","subject":{"id":"d322bfef-5135-599f-82e6-0aa58748dc8b","slug":"folic-acid","display_name":"Folic acid","entity_type_key":"small_molecule"},"object":{"id":"c010fdff-949d-5010-b699-cef668a70c37","slug":"advanced-colorectal-lesion-incidence","display_name":"Advanced colorectal lesion incidence","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"2cd84b4c-ce49-5df9-b241-0df0fd5afc8b","stable_key":"ec174d5a-4903-5745-8646-df0e9d4265e8:fol-advanced-lesion-later-signal-event","event_type":"observed_intervention","label":"The later follow-up raised a possible adverse signal that must remain visible.","description":"Among 607 participants with a second follow-up, advanced lesions occurred in 11.6% versus 6.9% (RR 1.67; 95% CI 1.00–2.80; P=0.05).","status":"provisional","compartment":null,"participants":[{"entity":{"id":"d322bfef-5135-599f-82e6-0aa58748dc8b","slug":"folic-acid","display_name":"Folic acid","entity_type_key":"small_molecule"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"c010fdff-949d-5010-b699-cef668a70c37","slug":"advanced-colorectal-lesion-incidence","display_name":"Advanced colorectal lesion incidence","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""}]},"contexts":[{"dimension":"experimental_model","value_text":"Randomized double-blind factorial trial in 1021 adults with recent colorectal adenomas; independently randomized aspirin exposure.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"exposure","value_text":"Folic acid 1 mg/day versus placebo; colonoscopy at first three-year interval and a later surveillance interval.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Secondary endpoint with substantial follow-up attrition and uncertainty; cannot establish that food folate causes cancer or identify the cellular mechanism.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Folate and folic acid research collection; topical membership is not evidence of a direct dietary effect.","comparator":null,"unit":null,"notes":"","entity":{"slug":"folate","display_name":"Folate (vitamin B9)","entity_type_key":"chemical_species"}},{"dimension":"organism","value_text":"Homo sapiens","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"plain_language","value_text":"The later follow-up raised a possible adverse signal that must remain visible.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"[fol-cole2007] Folic acid for the prevention of colorectal adenomas: a randomized clinical trial (2007). https://pubmed.ncbi.nlm.nih.gov/17551129/ DOI: 10.1001/jama.297.21.2351","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"tissue_or_cell_type","value_text":"Human blood or whole-person clinical endpoints","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"2cf27220-dcdc-51c9-b689-600f7caaf619","evidence_kind":"source_excerpt","locator":"Lines 1666-1676","start_line":1666,"end_line":1676,"excerpt":"### fol-advanced-lesion-later-signal\nAmong 607 participants with a second follow-up, advanced lesions occurred in 11.6% versus 6.9% (RR 1.67; 95% CI 1.00–2.80; P=0.05).\nCondition category: normal\nnutrient_topic: Folate and folic acid research collection; topical membership is not evidence of a direct dietary effect.\nplain_language: The later follow-up raised a possible adverse signal that must remain visible.\norganism: Homo sapiens\ntissue_or_cell_type: Human blood or whole-person clinical endpoints\nexperimental_model: Randomized double-blind factorial trial in 1021 adults with recent colorectal adenomas; independently randomized aspirin exposure.\nlimitations: Secondary endpoint with substantial follow-up attrition and uncertainty; cannot establish that food folate causes cancer or identify the cellular mechanism.\nexposure: Folic acid 1 mg/day versus placebo; colonoscopy at first three-year interval and a later surveillance interval.\n[fol-cole2007] Folic acid for the prevention of colorectal adenomas: a randomized clinical trial (2007). https://pubmed.ncbi.nlm.nih.gov/17551129/ DOI: 10.1001/jama.297.21.2351","model_system":"Randomized double-blind factorial trial in 1021 adults with recent colorectal adenomas; independently randomized aspirin exposure.","directness":"author_interpretation","verification_status":"source_derived_draft","notes":"Exact curation-document quotation, not publisher quotation. Study references: [fol-cole2007] Folic acid for the prevention of colorectal adenomas: a randomized clinical trial (2007). https://pubmed.ncbi.nlm.nih.gov/17551129/ DOI: 10.1001/jama.297.21.2351","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"f4ce1a62-9582-5f7a-84f5-a23d0e1bfc68","stable_key":"import-ec174d5a-4903-5745-8646-df0e9d4265e8","title":"Folate and folic acid: mechanisms, deficiency and nutrient interactions (2026-09-17)","document_type":"imported_text","citation_label":"AI-assisted literature curation; primary study URLs and scope retained in the document and extraction. Not publisher full text.","file_path":"","sha256":"e564d43989ece1006c95cd0748e9af6fe369074599a2eebba0a99ebff864b0dd","revision_id":"76674a33-b2a1-5e41-b71b-44399038ff7c","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}