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The aim of our study was to assess any association of folate with development of colonic adenomas.Serum and red blood cell folate levels were measured in 62 colonoscopically and histologically evaluated patients with colon adenomas (Group A) and in 50 selected colonoscopically negative controls (Group B). Patients with colon polyps underwent colonoscopy for alterations of bowel habits or abdominal pain, and detected polyps were found coincidentally. Controls underwent colonoscopy for alterations of bowel habits or abdominal pain. There was no difference in hematocrit between the two groups.The mean serum folate level in patients with colonic adenomas was 4.57 ng/ml±2.8 standard deviations (SD), and the mean red blood cells folate levels were 536 ng/ml±273.3 (SD). In controls the mean folate levels in serum and red blood cells were 5.09 ng/ml±2.7 (SD) and 7438 ng/ml±297.1 (SD), respectively. The red blood cell folate level of colon adenoma patients was statistically lower than the respective level of controls at a highly significant level (P<0.01).We suggest that depressed red blood cell folate levels are associated with development of colonie adenomas.