We read with great interest the article by Mathers and colleagues (1) on the large impact of resistant starch intake on the extracolonic cancer risk in Lynch syndrome (LS). Even though these analyses did not confirm the original hypothesis when starting this intervention study, that is, no impact on colon cancer risk was found, the outcomes of this study should be taken into account when formulating lifestyle advice because extracolonic cancers are more difficult to detect with screening.

Although the size of the cohort and follow-up time is impressive and numbers are convincing, some questions came up, which need to be answered before specific dietary recommendations can be given to patients with LS.

In fact, LS is a composite term for several hereditary disorders. Germline pathogenic variants in the MLH1, MSH2 (including Epcam) MSH6, and PMS2 mismatch repair genes all lead to an increased cancer risk....

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