BACKGROUND: Polymorphisms of the folate-associated one-carbon metabolism (OCM) pathway genes may regulate certain susceptibilities to cancer. G80A, a polymorphism in the reduced folate carrier (RFC) gene, may be associated with cancer risk, although the results obtained from previous studies have been inconsistent. OBJECTIVES: This study aimed to evaluate the association of G80A with lung cancer among a Chinese population and to examine the potential effect modifiers. METHODS: A nested, case-control study was performed in a population from the China H-type Hypertension Registry Study (CHHRS), in which 492 cases of lung cancer incidence and 1:1 matched controls were enrolled. RFC G80A variants were genotyped, and a series of metabolites in the OCM metabolic pathway were detected. Conditional logistic regression was used to model the association between this variant and lung cancer. RESULTS: After adjusting for potential confounders, compared with GG carriers, AG carriers showed a trend of increased lung cancer risk [adjusted odds ratio (OR): 1.37
95% CI: 0.97, 1.94], and AA carriers showed a significantly increased risk (adjusted OR: 1.86
95% CI: 1.16, 2.97
P = 0.010
P-trend = 0.009). In subsequent stratification analyses, a significant interaction effect from the pronounced risk-enhancing effect of the 80AA/GG genotypes was observed in participants with lower baseline serum methionine concentrations (<
4.6 μg/mL-adjusted OR: 2.63
95% CI: 1.40, 4.96
compared with ≥4.6 μg/mL-adjusted OR: 1.17
95% CI: 0.82, 1.66
P-interaction = 0.030). CONCLUSIONS: Taken together, these findings suggest that RFC G80A may influence the susceptibility of lung cancer and may also be a potential biomarker for lung cancer prevention.