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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.

The authors did not provide the same information for the second follow-up interval, when the increased risk for advanced lesions among the folic acid . . . [Full Text of this Article]

Young Kwang Chae, MD, MPH, MBA
ychae@jhsph.edu

Jeong Hyun Yun, MD, MPH
Johns Hopkins University
Baltimore, Maryland

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