OBJECTIVES: Primary * Compare celecoxib vs placebo, in terms of decreasing the incidence of adenomatous polyps of the colon and rectum, in patients with resected stage I adenocarcinoma of the colon. Secondary * Compare disease-free survival of patients treated with these regimens. * Compare the effect of these regimens on self-reported symptoms and health-related quality of life of these patients. * Compare the quality of life of patients treated with these regimens. * Compare the benefits of celecoxib in patients with primary tumors or polyps that express cyclo-oxygenase-2 (COX-2) with those that do not express COX-2. * Compare the expression of signaling targets such as serine/threonine AKT, extracellular signal-regulated kinase 2 (ERK2), and endoplasmic reticulum Ca+2- ATPases in the index tumor and polyps. * Determine the toxicity and safety of celecoxib in these patients. OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to gender, tumor stage (T1 vs T2), age (≤ 49 vs 50 to 59 vs ≥ 60 years), and current aspirin use (yes vs no). Patients are randomized to 1 of 2 treatment arms. * Arm I: Patients receive oral celecoxib twice daily for 3 years. * Arm II: Patients receive oral placebo twice daily for 3 years. In both arms, treatment continues in the absence of unacceptable toxicity or the diagnosis of invasive colon cancer, carcinoma in situ of the colon or rectum, or a non-colon primary cancer. Quality of life is assessed at baseline and then at 6, 12, 24, 36, and 42 months. Patients are followed at 6 months and at 2 years. PROJECTED ACCRUAL: A total of 1,200 patients (600 per treatment arm) will be accrued for this study within 2.5 years.
DISEASE CHARACTERISTICS: * Histologically confirmed adenocarcinoma of the colon * Stage I disease * Distal border of tumor ≥ 12 cm from the anal verge * Tumor completely resected within the past 90 days * Must have undergone a preoperative or postoperative colonoscopy to the cecum (or small bowel anastomosis) within the past 90 days * All observed polyps must have been removed * Patients with a history suggestive of hereditary non-polyposis colorectal cancer (HNPCC) must have a normal microsatellite instability status by immunohistochemistry or polymerase chain reaction * Patients with family history of colon cancer who have not been diagnosed with HNPCC are eligible * No prior familial adenomatous polyposis * No prior invasive cancer or carcinoma in situ of the colon or rectum * No clinical or radiologic evidence of metastatic disease PATIENT CHARACTERISTICS: Age * 18 and over Performance status * Zubrod 0-1 Life expectancy * At least 10 years Hematopoietic * Complete blood count normal * Platelet count normal Hepatic * Aspartate aminotransferase (AST) normal * Bilirubin normal * Alkaline phosphatase normal Renal * Creatinine normal Cardiovascular * No active ischemic heart disease * No New York Heart Association class III or IV heart disease * No myocardial infarction within the past 6 months * No symptomatic arrhythmia * No symptomatic peripheral vascular disease or carotid disease that would preclude study participation Pulmonary * No aspirin-sensitive asthma Gastrointestinal * No history of inflammatory bowel disease * No history of upper gastrointestinal bleeding * No history of duodenal or gastric ulcer Other * No known hypersensitivity to any COX-2 inhibitor, NSAIDs, aspirin, or sulfonamides * No non-colorectal malignancy within the past 5 years except carcinoma in situ of the cervix, melanoma in situ, or basal cell or squamous cell skin cancer * No other disease that would preclude study participation * No psychiatric disorders, including history of clinical depression or addictive disorders, that would preclude giving informed consent or long-term compliance * No rheumatologic or skeletal disorders requiring chronic NSAIDs or steroid therapy * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * Not specified Endocrine therapy * Not specified Radiotherapy * Not specified Surgery * See Disease Characteristics Other * No other concurrent investigational agents for colon cancer * No concurrent chronic use of other cyclo-oxygenase-2 (COX-2) inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), or salicylates (e.g., aspirin) * Chronic use is defined as use for more than an average of 3 days per month * Concurrent NSAIDs allowed for up to 10 consecutive days for temporary relief due to inflammatory syndromes, injury, or postoperative pain * Cardioprotective doses of aspirin (≤ 81 mg/day or 325 mg every other day) allowed * No concurrent fluconazole or lithium
are designated in this study
of being blinded to the placebo group