Inadequate vegetable intake appears to increase colon cancer risk. Since genetic variation in taste influences vegetable preference, we tested associations between bitterness of 6-n-propylthiouracil (PROP), a measure of taste genetics, and number of colonic polyps, a measure of colon cancer risk, in 251 men who underwent screening lower endoscopy. Patients used the general Labeled Magnitude Scale to rate bitterness of 1.6 mg PROP delivered via filter paper. A subset of 86 patients reported weekly vegetable intakes, excluding salad or potatoes. PROP bitterness correlated significantly with polyp number, an effect separate from age-associated increases in polyp number. The PROP-polyp relationship was strongest in men over 66 years, and older men with polyps were most likely to be overweight or obese. In the subset reporting vegetable intake, men who tasted PROP as more bitter consumed fewer vegetables. These preliminary findings suggest that taste genetics may influence colon cancer risk, possibly through intake of vegetables.

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Although evidence that aspirin and NSAIDs increase the risk of signi®cant bleeding after colonic polypectomy is lacking, aspirin prolongs colonic mucosal bleeding and NSAID use predisposes to minor bleeding after upper or lower endoscopy and biopsy or polypectomy. 1±3 The rate of major bleeding in the latter study was too low to assess an NSAID effect.Concerns about bleeding after polypectomy in aspirin or NSAID users have prompted three strategies. First, dermal bleeding times are used to screen patients before signi®cant polypectomy. However, bleeding times in the colonic mucosa (`endoscopic bleeding time') may not correlate with skin bleeding times in NSAID users. 2 Second, endoscopy is performed during NSAID use and patients with lesions are asked to cease NSAIDs before a second endoscopy for biopsy or polypectomy. In a population at high risk for lesions, this may be uncomfortable, expensive, and complication-prone. Third, all patients are asked to stop aspirin and NSAIDs 1±2 weeks in advance, engendering considerable discom®ture in patients who require NSAIDs for analgesia. NSAIDs with little effect on platelet function in vivo provide a potentially attractive alternative as a bridge to and through endoscopy. Such NSAIDs would include nabumetone, which has insuf®cient effect on thromboxane synthesis in vivo (COX-1 mediated) to substantially affect platelet aggregation, and selective COX-2 inhibitors, which do not affect COX-1 at therapeutic SUMMARY Background: The management of patients taking aspirin or non-steroidal anti-in¯ammatory drugs (NSAIDs) who require colonoscopy remains controversial because of concerns over bleeding after biopsy or polypectomy. Aim: To determine whether patients using the NSAID nabumetone, a non-acidic prodrug with mixed activity against cyclooxygenase-1 (COX-1) and COX-2, exhibited prolonged mucosal bleeding times and how this might compare with mucosal bleeding times in patients using aspirin. Methods: We assessed triplicate mucosal bleeding times in patients undergoing screening¯exible sigmoidoscopy. We compared 90 patients who had taken no aspirin or NSAIDs within the previous 2 weeks, to 60 patients