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Colorectal cancer is the third most commonly detected cancer and the second leading cause of cancer-related deaths in the U.S. Many agents have been studied as possible “cancer-protective” therapies — some have proven to be ineffective (Journal Watch Oncology and Hematology Jul 2 2007). However, the use of aspirin and other agents that inhibit prostaglandin-generating cyclooxygenase (COX) pathways reduces both the incidence of colorectal polyps and colorectal cancer. How these agents affect development of polyps and cancers is unclear, although we know that the COX-2 enzyme is overexpressed in some polyps and cancers. Recent trials indicate that specific COX-2 inhibitors reduce the incidence of colorectal adenomatous polyps but at the cost …