We thank Drs. Nielsen and van Duijnhoven for their interest in our paper (1) and for their recognition of the importance of our findings as a basis for dietary advice for patients with Lynch syndrome (LS). Participants in the CAPP2 Study, randomized to receive supplemental resistant starch (RS) during the intervention trial (mean 29 months), had significantly lower risk of extracolonic cancers, notably lower risk of cancers of the upper gastrointestinal (GI) tract, when followed up 10 to 20 years later (1). This finding is especially significant given that such cancers are more difficult to manage, and that 10-year survival is much lower for upper GI cancer (58%), than for colorectal cancer (91%; ref. 2). Drs. Nielsen and van Duijnhoven ask two questions: (i) Does RS have similar beneficial effects in lowering the risk of extracolonic cancers in patients with LS with different germline mutations?...

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