We thank Drs Ponzetto and Figura for their interest in our study entitled “Serological response to Helicobacter pylori proteins associate with risk of colorectal cancer among diverse populations in the United States.” We appreciate their comments on a potential causal relation between H pylori VacA protein and colorectal cancer development. Their hypothesis that VacA may increase the risk of colorectal cancer through a mechanism that is similar to that identified for cystic fibrosis could be of great importance to the question of how H pylori might contribute to colorectal carcinogenesis.