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In Reply: In response to Drs Chae and Yun, we evaluated an interaction of aspirin and folic acid on the risk of adenomas during the second colonoscopic follow-up interval, using the statistical methods for intention-to-treat analysis described in our article. Participants randomized to 1 mg/d of folic acid had higher rates of colorectal adenomas than those randomized to placebo in each of the 3 aspirin treatment groups (placebo, 81 mg/d, and 325 mg/d); in addition, the folic acid group had higher rates of advanced lesions in the aspirin placebo and 325 mg/d of aspirin groups (Table). These estimates had larger variances than those in the first follow-up interval due to smaller numbers of participants with end point information. There was no significant interaction between aspirin and folic acid for any adenoma (unadjusted P = .97) or for any advanced lesion (unadjusted P = .27) in the second follow-up interval. Adjustment . . . [Full Text of this Article]

Bernard F. Cole, PhD
bernard.cole@dartmouth.edu
Department of Community and Family Medicine

John A. Baron, MD
Department of Medicine

Leila A. Mott, MS
Department of Community and Family Medicine
Dartmouth Medical School
Hanover, New Hampshire

RELATED LETTER

Folic Acid and Prevention of Colorectal Adenomas
Young Kwang Chae and Jeong Hyun Yun
JAMA. 2007;298(12):1397.
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