New York, June 30, 2000 (Praxis Press) In familial adenomatous polyposis (FAP), a genetic disease that spurs the formation of hundreds of adenomatous polyps in the colon, the risk of developing colorectal cancer verges on 100 percent. Nonsteroidal antiinflammatory drugs (NSAIDs) are linked to a lower incidence of adenomatous polyps and lower colon cancer mortality, possibly due to their inhibition of the cyclooxygenase enzyme family, but their gastrointestinal toxicity limits their long-term use. In a recent study published in The New England Journal of Medicine, a six-month twice-daily treatment with 400 mg of celecoxib, a specific cyclooxygenase-2 inhibitor not associated with the gastric ulceration linked to traditional NSAIDs, significantly reduced the number of colorectal polyps in patients with FAP (see paper). After six months, patients had a 28 percent reduction in the mean number of colorectal polyps and a 30.7 percent reduction in the polyp burden. These findings suggest that celecoxib may become part of the pharmacologic strategy for the prevention of colorectal adenomas, once its long-term effects are evaluated.