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September 26, 2007

Folic Acid and Prevention of Colorectal Adenomas

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;298(12):1397. doi:10.1001/jama.298.12.1397-a

To the Editor: In their randomized controlled trial of folic acid for prevention of colorectal adenomas, Dr Cole and colleagues1 reported an increased risk for advanced colorectal adenoma lesions and adenoma multiplicity in the folic acid group. This difference in risk became statistically significant in the second follow-up interval. The authors also noted that randomized aspirin treatment did not modify the effect of folic acid on adenomas in the first follow-up interval. However, Figure 2 in the article indicates that the aspirin placebo subgroup, but not the 2 active aspirin subgroups (81 mg/d and 325 mg/d), seemed to be associated with an increased frequency of advanced lesions in the folic acid group during the first follow-up interval, although this did not appear to reach statistical significance.