Altered folate and vitamin b12 status in NMSC patients: Insights from the all of us research program

Summary: Abstract Body: This study examines the association between folate (B9) and cobalamin (B12) deficiencies or excess and the risk of developing non-melanoma skin cancer (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). A cross-sectional analysis was conducted using data from the All of Us Research Program. Folate and B12 levels were measured in patients within one year of being diagnosed with either basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). Folate deficiency and excess were defined as <4 ng/mL and >20 ng/mL, respectively. B12 deficiency was defined as <200 pg/mL, and excess as >914 pg/mL. Folate deficiency was more prevalent in SCC (3.94%) and BCC (3.07%) patients compared to the U.S. average (~1%, p<<0.001). Folate excess occurred in 17.16% of SCC and 21.16% of BCC cases, though national comparisons were unavailable. Vitamin B12 deficiency was less common in SCC (4.40%) and BCC (5.15%) patients compared to the general population (10.06%, p<<0.001). However, B12 excess was more prevalent in SCC (24.25%) and BCC (22.11%) patients versus the general population (18%, p<<0.001). These findings reveal distinct patterns in folate and B12 levels among NMSC patients. Elevated folate levels, possibly linked to supplementation, may have dual roles in cancer, preventing early development but promoting progression. Higher B12 levels, potentially associated with solid cancers incidence and increased all-cause mortality, also warrant further investigation into the underlying mechanisms. This study emphasizes the need for further research on vitamin B complex levels in NMSC and the potential implications of supplementation in at-risk populations. Jacqueline Kunesh¹, Abarajithan Chandrasekaran¹, Tyler Chinyere¹ 1. The University of Arizona College of Medicine Phoenix, Phoenix, AZ, United States. UV Biology/Injury and Non-melanoma Cancers