Polyphenon E in Treating Patients With High-Risk of Colorectal Cancer

Inclusion Criteria:

* Current or prior advanced adenomas. Participants with advanced adenomas are defined as participants who have polyps \>= 1 cm, who have tubulovillous adenomas (25-75 percent villous features), who have villous adenomas (\>75 percent villous), or who have severe dysplasia
* Prior curatively resected Tumor, Node, Metastasis (TNM) stage II and III colon cancer \>= 3 years out from treatment by surgery with/without adjuvant chemotherapy; NOTE: patients with stage I (T1,2 N0) colon cancer treated by endoscopic or surgical therapy are eligible at anytime after such therapy; patients with prior stage IV disease must be \>= 5 years status post surgical resection of all metastatic disease
* Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1
* Ability to understand and the willingness to sign a written informed consent document
* Willingness to discontinue regular usage of calcium supplements; Exception: multi-vitamin; regular use defined as a frequency of 7 consecutive days for \> 3 weeks
* Willingness to provide mandatory tissue and blood for protocol specified research; residual tissue and/or blood may be used for future research Negative pregnancy test =\< 7 days prior to registration/randomization
* Hemoglobin (Hgb) \>= 12.0 g/dL (women), \>= 13.5 g/dL (men) at Mayo Clinic or within normal limits at an outside laboratory
* Platelet count \>= 100,000/ul
* White blood cells (WBC) \>= 3,000/ul
* Alanine aminotransferase (ALT) within institutional limits of normal
* Alkaline phosphatase within institutional upper limit of normal (ULN)
* Aspartate aminotransferase (AST) within institutional limits of normal
* Total bilirubin within institutional limits of normal
* Serum calcium =\< institutional ULN
* Serum creatinine =\< 1.5 x institutional ULN
* \>= 5 rectal ACF detected by chromoendoscopy =\< 45 days prior to registration/randomization
* Endoscopy =\< 45 days prior to registration/randomization; Note: All adenomas or polyps will be removed according to institutional standards of care, and the cecum must visualized; this may be done at the same time as the chromoendoscopy

Exclusion Criteria:

* Any history of rectal cancer; Exception: transanal excision without radiation
* Known diagnosis of colon heritable cancer syndrome (Familial adenomatous polyposis \[FAP\], hereditary nonpolyposis colorectal cancer \[HNPCC\]) or inflammatory bowel disease (Crohn's disease, ulcerative colitis)
* Inability to swallow capsules
* Bleeding diathesis
* Any invasive malignancy =\< 5 years prior to pre-registration;

  * Exceptions:
  * patients with nonmelanoma skin cancers that were treated with simple excisional biopsy or stage I (T1,2 N0)
  * colon cancer treated by endoscopic therapy or surgery are eligible
* History of gastroduodenal ulcers documented =\< 1 year
* Known inability to participate in the scheduled follow-up tests
* Significant medical or psychiatric problems which would make the participant a poor protocol candidate, in the opinion of the treating physician
* Total colectomy
* Colostomy
* History of pelvic or rectal radiation therapy
* History of liver disease
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia
* Concomitant corticosteroids or anticoagulants needed on a regular or predictable intermittent basis
* Use of non-study investigational agent(s) =\< 3 months prior to preregistration
* Chemotherapy =\< 6 months prior to pre-registration; Note: Topical chemotherapy will be assessed on a case-by-case basis
* Any of the following: \* Pregnant women \* Nursing women \* Men or women of childbearing potential who are unwilling to employ adequate contraception Note: This study involves an investigational agent whose genotoxic, mutagenic, and teratogenic effects on the developing fetus and newborn are unknown
* Over-the-counter green tea or green tea extract use =\< 6 weeks prior to pre-registration; consumption of over the counter green tea extracts or drinking of green tea is not permitted during the treatment portion of this trial
* Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) =\< 6 weeks prior to pre-registration; regular use of NSAIDs is defined as a frequency of 7 consecutive days (1 week) for \> 3 weeks; participant must abstain from regular use of NSAIDs for the duration of the study; Exception: low dose aspirin (81 mg) for those participants who are chronic users of aspirin prior to the beginning of the study
* Use of non-study investigational agents while on study