With each method of COX -2 inhibition there are slightly different courses of action. Hence the two unique patents on Vioxx and Celebrex. Do they both cause problems? The manufacturer of Celebrex says that their studies did not show the adverse effects of the Vioxx group, but they are undertaking a separate set of studies (not required of them) to establish this for sure. That to me is the mark of a company that not only is covering their financial ass, but is perhaps also genuinely concerned with more than the bottom line. The FDA has not asked them to do this at a significant expense. (On the other hand some risk management consultant probably told them that it was the prudent thing to do.) I have been taking very low doses of Celebrex. I see a cardiologist for other issues that were of interest to me, not related to clinical cardiac need or cancer. He reminded me that while there have been issues with some individuals and cox-2 inhibitors (Vioxx), the issue in the news is a reflection of legal/financial defense and to pay attention to the small numbers of individuals (out of millions that took the drug) who were impacted negatively by it. The data that revealed the problem has not identified what those who had a negative reaction to it had in common. So essentially while those impacted were a small number, even one is too many if you DO NOT NEED the medication. When it comes to chemoprevention, the argument could be easily made that we do not need the medication and therefore it is not worth the unknown level of risk. So I began looking at alternative cox-2 inhibitors. Certainly the naproxen avenue which is over the counter as Aleve is one option that has an extremely low adverse reaction rate, (low enough for the FDA to move it from a Rx drug to and over-the-counter drug), and then there are herbal cox-2 inhibitors as well. A trip to any health food store will allow you to locate a variety of herbal combination supplements (some with 8 or more herbal ingredients) that have some of the same cox-2 reduction effects. For those with any concerns, these would seem the most appropriate, though their strength will be significantly reduced. But there is not an established level of inhibition which has been determined to be effective in recurrence prevention (and published as such), so perhaps these would offer enough from a chemoprevention standpoint, and even enough to alternate with the Aleve that I take for my many back problems, (and inflammatory pain), from falling out of the sky in helicopters too often. This doesn't answer your question with a finite answer, but it is the best I can offer.