Celecoxib in Preventing Colorectal Cancer in Young Patients With a Genetic Predisposition for Familial Adenomatous Polyposis

Inclusion criteria

DISEASE CHARACTERISTICS: * Diagnosis of familial adenomatous polyposis (FAP) based on genetic predisposition testing * Genotype-positive FAP (pathologic Adenomatous polyposis coli (APC) mutation) * No attenuated FAP genotype, defined by any of the following: * Mutation at the 5' end of APC and exon 4 * Exon 9-associated phenotypes * 3' region mutations * Has an intact colon * No requirement for colectomy * Parent(s) do not desire colectomy (regardless of adenoma burden) * Colorectal adenoma burden as assessed by baseline colonoscopy * No diagnosis of severe dysplasia or greater * No more than 10 adenomas ≥ 1 cm * No more than 100 adenomas of any size * No evidence of anemia (hematocrit \< 33%) * No new diagnosis of carcinoma PATIENT CHARACTERISTICS: * White Blood Count (WBC) \> 3,000/μL * Platelet count \> 100,000/μL * Hemoglobin \> 10.0 g/dL * Aspartate aminotransferase/alanine aminotransferase (AST/ALT) \< 1.5 times upper limit of normal (ULN) * Alkaline phosphatase \< 1.5 times ULN * Total bilirubin \< 1.5 times ULN * Creatinine \< 1.5 times ULN * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * No history of hypersensitivity to COX-2 inhibitors, sulfonamides, NSAIDs, or salicylates * No history of peptic ulcer disease * No significant medical or psychiatric problem that, in the opinion of the principal investigator, would make the patient a poor candidate for the study * No other unacceptable clinical risk (e.g., previously unknown bleeding diatheses) * No invasive carcinoma within the past 5 years PRIOR CONCURRENT THERAPY: * More than 3 months since prior investigational agent * More than 6 months since prior chemotherapy * No prior radiotherapy to the pelvis * At least 3 months since prior NSAIDs (at any dose) at a frequency of ≥ 3 times/week * At least 1 month since prior NSAIDs (at any dose) at a frequency of \< 3 times/week * At least 1 month since prior nasal steroids * Concurrent Nonsteroidal Antiinflammatory Drugs (NSAIDs) allowed provided they are administered ≤ 5 times per month * Concurrent orally inhaled steroids allowed provided they are administered for ≤ 4 weeks over a 6-month period * Concurrent oral or intravenous (IV) corticosteroids allowed provided they are administered for ≤ 2 consecutive weeks over a 6-month period * Concurrent proton pump inhibitors to treat gastric reflux allowed * No concurrent nasal steroids except mometasone (Nasonex) * No concurrent fluconazole, lithium, or adrenocorticosteroids